Provider Demographics
NPI:1639529357
Name:SINGH, PARAMJIT
Entity Type:Individual
Prefix:
First Name:PARAMJIT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2908
Mailing Address - Country:US
Mailing Address - Phone:917-238-9663
Mailing Address - Fax:718-876-9104
Practice Address - Street 1:21 BROOK ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2908
Practice Address - Country:US
Practice Address - Phone:917-238-9663
Practice Address - Fax:718-876-9104
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB01453344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03646811Medicaid