Basic Information
Provider Information
NPI: 1134359573
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: DEEPAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7559 263RD ST
Address2: ACP BUILDING, BASEMENT
City: GLEN OAKS
State: NY
PostalCode: 110041150
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7559 263RD ST
Address2: ACP BUILDING, BASEMENT
City: GLEN OAKS
State: NY
PostalCode: 110041150
CountryCode: US
TelephoneNumber: 7184704834
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/20/2009
LastUpdateDate: 07/30/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X004130NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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