=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194718486
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RANJIT SINGH MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2005
-----------------------------------------------------
Last Update Date | 09/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 462 GRIDER ST
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14215-3021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-898-5647
-----------------------------------------------------
Fax | 716-898-3536
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 637 MOUNTAIN VIEW DR
-----------------------------------------------------
City | LEWISTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14092-1909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-282-5545
-----------------------------------------------------
Fax | 716-282-5545
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 250060
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------