Healthcare Provider Details

I. General information

NPI: 1669309100
Provider Name (Legal Business Name): GANEEV SINGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST, BOSTON, MA 02135
BOSTON MA
02135
US

IV. Provider business mailing address

736 CAMBRIDGE ST, BOSTON, MA 02135
BOSTON MA
02135
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3020516
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: