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General NPI Number Information
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NPI Number | 1063595114
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Entity Type | Individual
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Provider Name | SAWARAN SINGH BAMBRAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 320 PRATHER AVE
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City | JAMESTOWN
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State | NY
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Zip | 14701-6820
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Country | US
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Telephone | 716-488-0776
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Fax | 716-664-9092
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Provider Business Mailing Address
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Address Line | 56 NOTTINGHAM CIR
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City | JAMESTOWN
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State | NY
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Zip | 14701-5719
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Country | US
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Telephone | 716-488-9002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 116091
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License Number State | NY
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