=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770720211
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TARUNJIT SINGH MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2009
-----------------------------------------------------
Last Update Date | 11/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13112 LIBERTY AVE
-----------------------------------------------------
City | SOUTH RICHMOND HILL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11419-3124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-843-1020
-----------------------------------------------------
Fax | 718-843-0370
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30 GARDNER AVE
-----------------------------------------------------
City | HICKSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11801-2547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-356-7377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 266794
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | 266794
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------