Healthcare Provider Details

I. General information

NPI: 1780787770
Provider Name (Legal Business Name): MEENAKSHI SINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SBUMC DEPT OF PATHOLOGY
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

PO BOX 1559
STONY BROOK NY
11790-0989
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-3000
  • Fax:
Mailing address:
  • Phone: 631-444-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number37122
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number251103
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: