Healthcare Provider Details

I. General information

NPI: 1730749128
Provider Name (Legal Business Name): JYOTI SINGH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89-65 162ND STREET
JAMAICA NY
11432
US

IV. Provider business mailing address

89-65 162ND STREET
JAMAICA NY
11432
US

V. Phone/Fax

Practice location:
  • Phone: 347-505-7000
  • Fax:
Mailing address:
  • Phone: 347-505-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number316836
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: