Healthcare Provider Details

I. General information

NPI: 1881334662
Provider Name (Legal Business Name): JAY SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W MAIN ST STE C
MAPLE SHADE NJ
08052-2411
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-779-7386
  • Fax: 856-779-7563
Mailing address:
  • Phone: 856-779-7386
  • Fax: 856-779-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA12818300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: