Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 146886 | NY |
NPI | 1225153133 |
---|---|
Provider Name | Virendra Singh |
First Address | Ogdensburg, NY 13669-2212 |
Second Address | Ogdensburg, NY 13669-2212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146886 | (05) | NY |
C10864 | (02) | NY |