Healthcare Provider Details

I. General information

NPI: 1457507980
Provider Name (Legal Business Name): JASVIR SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1048 BEACH 20TH ST
FAR ROCKAWAY NY
11691-3900
US

IV. Provider business mailing address

PO BOX 746087
ATLANTA GA
30374-6087
US

V. Phone/Fax

Practice location:
  • Phone: 718-765-6345
  • Fax: 929-374-1132
Mailing address:
  • Phone: 833-804-1695
  • Fax: 312-929-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number260351
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: