Provider Demographics
NPI:1720016660
Name:SINGH, SASENARINE (GNP)
Entity Type:Individual
Prefix:
First Name:SASENARINE
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 JASMINE AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042
Mailing Address - Country:US
Mailing Address - Phone:651-895-6193
Mailing Address - Fax:651-739-7192
Practice Address - Street 1:1690 UNIVERSITY AVE W STE 115
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3118
Practice Address - Country:US
Practice Address - Phone:651-232-2002
Practice Address - Fax:651-232-2031
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1117442363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR90119Medicare UPIN