Provider Demographics
NPI:1740373380
Name:SINGLETARY, LINDA A
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BRIGHTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 BRIGHTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1664
Practice Address - Country:US
Practice Address - Phone:718-876-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA064106002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6987109Medicaid
NJG42383Medicare UPIN
NJ6987109Medicaid