Healthcare Provider Details

I. General information

NPI: 1710151477
Provider Name (Legal Business Name): JASPAL RICKY SINGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 07/11/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST BAKER 16
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST BAKER 16
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-1500
  • Fax:
Mailing address:
  • Phone: 212-746-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number264245
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: