Healthcare Provider Details

I. General information

NPI: 1598064669
Provider Name (Legal Business Name): KULDEEP SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SEAVIEW AVE SUITE 302
STATEN ISLAND NY
10305-3419
US

IV. Provider business mailing address

501 SEAVIEW AVE SUITE 302
STATEN ISLAND NY
10305-3419
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-6800
  • Fax: 718-226-1295
Mailing address:
  • Phone: 718-226-6800
  • Fax: 718-226-1295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number251832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: