Healthcare Provider Details

I. General information

NPI: 1942465653
Provider Name (Legal Business Name): MANDEEP SINGH BHAMRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MANDEEP SINGH M.D.

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 WASHINGTON AVE STE 101
ALBANY NY
12206-1040
US

IV. Provider business mailing address

1375 WASHINGTON AVE STE 101
ALBANY NY
12206-1040
US

V. Phone/Fax

Practice location:
  • Phone: 518-533-5000
  • Fax: 518-599-2243
Mailing address:
  • Phone: 518-533-5000
  • Fax: 720-890-0364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number263952-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: