Basic Information
| Provider Information | |||||||||
| NPI: | 1538172036 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | AJAY | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 329 S PLEASANT AVENUE | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144453575 | ||||||||
| FaxNumber: | 8144458039 | ||||||||
| Practice Location | |||||||||
| Address1: | 126 EAST CHURCH ST | ||||||||
| Address2: | SUITE 2300 | ||||||||
| City: | SOMERSET | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144432888 | ||||||||
| FaxNumber: | 8144431789 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 06/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD020084E | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 0006026160001 | 05 | PA | MEDICAID |