Healthcare Provider Details

I. General information

NPI: 1902046055
Provider Name (Legal Business Name): TARUNDEEP SINGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 JEFFERSON AVE
SCRANTON PA
18510-1624
US

IV. Provider business mailing address

746 JEFFERSON AVENUE
SCRANTON PA
18510
US

V. Phone/Fax

Practice location:
  • Phone: 570-702-2292
  • Fax:
Mailing address:
  • Phone: 570-702-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT193464
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: