Healthcare Provider Details

I. General information

NPI: 1972619013
Provider Name (Legal Business Name): JAGMOHAN SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 STEUBEN STREET
MONTOUR FALLS NY
14865
US

IV. Provider business mailing address

220 STEUBEN ST
MONTOUR FALLS NY
14865-9740
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-7154
  • Fax: 607-535-7157
Mailing address:
  • Phone: 607-535-8639
  • Fax: 607-535-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number178890
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number178890
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: