Provider Demographics
NPI:1801394572
Name:SINGH, DEOL
Entity type:Individual
Prefix:
First Name:DEOL
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12117 LIBERTY AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2111
Mailing Address - Country:US
Mailing Address - Phone:347-476-4723
Mailing Address - Fax:
Practice Address - Street 1:12117 LIBERTY AVE FL 2
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2111
Practice Address - Country:US
Practice Address - Phone:347-476-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide