Provider Demographics
NPI:1790379444
Name:SINGER, SHOSHANAH
Entity Type:Individual
Prefix:
First Name:SHOSHANAH
Middle Name:
Last Name:SINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 BLACKSTONE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1421
Mailing Address - Country:US
Mailing Address - Phone:503-320-1824
Mailing Address - Fax:
Practice Address - Street 1:3722 BLACKSTONE AVE APT 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1421
Practice Address - Country:US
Practice Address - Phone:503-320-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist