Healthcare Provider Details

I. General information

NPI: 1639139629
Provider Name (Legal Business Name): SUNIL K. SINGH, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NEW RD
LINWOOD NJ
08221-1036
US

IV. Provider business mailing address

1801 NEW RD
LINWOOD NJ
08221-1036
US

V. Phone/Fax

Practice location:
  • Phone: 609-653-3055
  • Fax: 609-653-8469
Mailing address:
  • Phone: 609-653-3055
  • Fax: 609-653-8469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA04994600
License Number StateNJ

VIII. Authorized Official

Name: SUNIL KUMAR SINGH
Title or Position: OWNER
Credential: MD
Phone: 609-653-3055