Healthcare Provider Details

I. General information

NPI: 1326847997
Provider Name (Legal Business Name): NO NAME GIVEN GOLDENDEEP SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: GOLDENDEEP SINGH MD

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 EAST AVE
LOCKPORT NY
14094-3825
US

IV. Provider business mailing address

823 MONET LN
CLOVIS CA
93619-7688
US

V. Phone/Fax

Practice location:
  • Phone: 516-661-5621
  • Fax:
Mailing address:
  • Phone: 618-791-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number327686
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: