Basic Information
Provider Information
NPI: 1124276084
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DHAM
FirstName: BHAVPREET
MiddleName: SINGH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 ELMWOOD AVE BOX 278984
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5857849277
FaxNumber: 5854247289
Practice Location
Address1: 919 WESTFALL RD STE 220
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146182628
CountryCode: US
TelephoneNumber: 5853417500
FaxNumber: 5853417510
Other Information
ProviderEnumerationDate: 09/04/2008
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X288691NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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