Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DEN03310 | RI |
Y | 213EG0000X | General Practice | DEN03310 | RI |
NPI | 1003297052 |
---|---|
Provider Name | Jairahadeep Singh |
First Address | Providence, RI 02905-5010 |
Second Address | Providence, RI 02905-2426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 25/08/2016 |