Healthcare Provider Details

I. General information

NPI: 1588771372
Provider Name (Legal Business Name): MAURICE SINGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10663 BUSTLETON AVE
PHILADELPHIA PA
19116-3707
US

IV. Provider business mailing address

10663 BUSTLETON AVE
PHILADELPHIA PA
19116-3707
US

V. Phone/Fax

Practice location:
  • Phone: 215-676-3336
  • Fax: 215-671-0799
Mailing address:
  • Phone: 215-676-3336
  • Fax: 215-671-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS003261L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: