Provider Demographics
NPI:1851338164
Name:SINGH, JAGJIT (MD)
Entity Type:Individual
Prefix:
First Name:JAGJIT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11415 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1138
Mailing Address - Country:US
Mailing Address - Phone:718-641-9874
Mailing Address - Fax:718-641-0343
Practice Address - Street 1:11415 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1138
Practice Address - Country:US
Practice Address - Phone:718-641-9874
Practice Address - Fax:718-641-0343
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH47669Medicare UPIN