Basic Information
| Provider Information | |||||||||
| NPI: | 1922332030 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | IQUINDER | ||||||||
| MiddleName: | PAL-KAUR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 ROCKAWAY TPKE | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115591216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163745024 | ||||||||
| FaxNumber: | 5163745816 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 ROCKAWAY TPKE | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115591216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163745024 | ||||||||
| FaxNumber: | 5163745816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2009 | ||||||||
| LastUpdateDate: | 12/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 254813 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 254813 | 01 | NY | STATE LISENCE | OTHER |