Provider Demographics
NPI:1760134605
Name:SINGH, R. MATTHEW (CPHT)
Entity Type:Individual
Prefix:
First Name:R. MATTHEW
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:RICHARD
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:73 LENAPE DR
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-9385
Mailing Address - Country:US
Mailing Address - Phone:516-557-9084
Mailing Address - Fax:
Practice Address - Street 1:4 EAGLES GLEN SHOPPING PLAZA
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301
Practice Address - Country:US
Practice Address - Phone:570-424-0830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30166369183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty