Healthcare Provider Details

I. General information

NPI: 1265452189
Provider Name (Legal Business Name): BIRENDRA SINGH WALIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BIRENDRA SINGH MD

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 OLD COUNTRY RD
PLAINVIEW NY
11803-4910
US

IV. Provider business mailing address

PO BOX 416173
BOSTON MA
02241-6173
US

V. Phone/Fax

Practice location:
  • Phone: 516-898-7299
  • Fax: 516-898-7301
Mailing address:
  • Phone: 610-644-8900
  • Fax: 484-924-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number241963-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA08319600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: