Provider Demographics
NPI:1942470398
Name:BAGGA, SIMRAN SINGH (DO)
Entity Type:Individual
Prefix:DR
First Name:SIMRAN
Middle Name:SINGH
Last Name:BAGGA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7559 263RD ST
Mailing Address - Street 2:ZUCKER HILLSIDE HOSPITAL, ACP BUILDING
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1150
Mailing Address - Country:US
Mailing Address - Phone:718-470-3154
Mailing Address - Fax:718-470-4678
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:ZUCKER HILLSIDE HOSPITAL, ACP BUILDING
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-3154
Practice Address - Fax:718-470-4678
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2587182084P0804X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program