Provider Demographics
NPI:1851158281
Name:SINGH, PRABHSIMRAN (MBBS)
Entity Type:Individual
Prefix:
First Name:PRABHSIMRAN
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-475-6900
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-475-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program