Healthcare Provider Details

I. General information

NPI: 1881440253
Provider Name (Legal Business Name): SIMRAN SINGH MAHAL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 12/06/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEISINGER COMMUNITY MEDICAL CENTER, 1800 MULBERRY STREE
SCRANTON PA
18510
US

IV. Provider business mailing address

217 EAST, 82 STREET APARTMENT C
NEW YORK NY
10028
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-8000
  • Fax:
Mailing address:
  • Phone: 646-806-2676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

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: