Provider Demographics
NPI:1477569416
Name:SINGER, MARK A (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:SINGER
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 1:325 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2779
Mailing Address - Country:US
Mailing Address - Phone:631-351-8487
Mailing Address - Fax:631-351-3729
Practice Address - Street 1:325 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2779
Practice Address - Country:US
Practice Address - Phone:631-351-8487
Practice Address - Fax:631-351-3729
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207815-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4C0581OtherHEALTHNET
NY025AN1OtherBLUE CROSS/ BLUE SHIELD
NY156432OtherGHI
NYP2220253OtherOXFORD
NY02148543Medicaid
NYH12583Medicare UPIN
NY02148543Medicaid