Provider Demographics
NPI:1336235084
Name:SINGH, DEVENDRA KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVENDRA
Middle Name:KUMAR
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 1:41 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940
Mailing Address - Country:US
Mailing Address - Phone:631-878-1543
Mailing Address - Fax:631-874-2559
Practice Address - Street 1:41 BAY AVE
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940
Practice Address - Country:US
Practice Address - Phone:631-878-1543
Practice Address - Fax:631-874-2559
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123643207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY123643OtherLICENCE NUMBER
NY00232540Medicaid
NY00232540Medicaid
NY123643OtherLICENCE NUMBER
NYB80225Medicare UPIN