Healthcare Provider Details

I. General information

NPI: 1972412096
Provider Name (Legal Business Name): CANDY BEAR PEDIATRICS TELEMEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SMYRNA GROVE DR
SMYRNA GA
30082-2831
US

IV. Provider business mailing address

3008 SMYRNA GROVE DR
SMYRNA GA
30082-2831
US

V. Phone/Fax

Practice location:
  • Phone: 201-543-4630
  • Fax:
Mailing address:
  • Phone: 201-543-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MANJIT KAUR SINGH
Title or Position: OWNER/CEO
Credential: MD
Phone: 912-856-1591