Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ01111100 | NJ |
NPI | 1033700034 |
---|---|
Provider Name | Kassidy Singh |
First Address | Kearny, NJ 07032-3384 |
Second Address | Kearny, NJ 07032-3384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2021 |
Last Update Date | 04/04/2021 |