Basic Information
Provider Information
NPI: 1922340413
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: MAURA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 950 CAMPBELL AVE # 240
Address2:  
City: WEST HAVEN
State: CT
PostalCode: 065162770
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber: 2034798148
Practice Location
Address1: 950 CAMPBELL AVE # 240
Address2:  
City: WEST HAVEN
State: CT
PostalCode: 06516
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber: 2034798148
Other Information
ProviderEnumerationDate: 03/22/2013
LastUpdateDate: 08/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0300X055395CTY Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine

No ID Information.


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