Provider Demographics
NPI:1811907108
Name:SINGH, SATYENDRA P (MD)
Entity type:Individual
Prefix:
First Name:SATYENDRA
Middle Name:P
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 1:101 PROSPECT ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5020
Mailing Address - Country:US
Mailing Address - Phone:732-905-0077
Mailing Address - Fax:
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5020
Practice Address - Country:US
Practice Address - Phone:732-905-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07342300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine