Healthcare Provider Details

I. General information

NPI: 1275528903
Provider Name (Legal Business Name): IRA JOEL SINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 01/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2138 MENDON RD NUMBER 302
CUMBERLAND RI
02864-3834
US

IV. Provider business mailing address

725 RESERVOIR AVE
CRANSTON RI
02910-4448
US

V. Phone/Fax

Practice location:
  • Phone: 401-334-1060
  • Fax: 401-334-1063
Mailing address:
  • Phone: 401-944-3800
  • Fax: 401-944-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD06412
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: