Provider Demographics
NPI:1629012968
Name:SINGH & NADELLA
Entity Type:Organization
Organization Name:SINGH & NADELLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VENKATESWARA RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-368-7000
Mailing Address - Street 1:6 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1903
Mailing Address - Country:US
Mailing Address - Phone:814-368-7000
Mailing Address - Fax:814-362-6243
Practice Address - Street 1:6 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1903
Practice Address - Country:US
Practice Address - Phone:814-368-7000
Practice Address - Fax:814-362-6243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000771851Medicaid
PA000771889Medicaid
PA006371D9SMedicare ID - Type Unspecified
PA000771851Medicaid
NYAA1250Medicare PIN
PAB30744Medicare UPIN
PAC26185Medicare UPIN