Provider Demographics
NPI:1134798705
Name:SINGH, SUKHJIT (COTA)
Entity type:Individual
Prefix:
First Name:SUKHJIT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6909
Mailing Address - Country:US
Mailing Address - Phone:845-300-2415
Mailing Address - Fax:
Practice Address - Street 1:160 OVERLOOK AVE APT 24B
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2231
Practice Address - Country:US
Practice Address - Phone:845-300-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09092700224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant