=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871765826
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MANIK SINGH M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2008
-----------------------------------------------------
Last Update Date | 02/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 328 W SAINT GEORGES AVE
-----------------------------------------------------
City | LINDEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07036-5638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-925-2273
-----------------------------------------------------
Fax | 908-925-2235
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 328 W SAINT GEORGES AVE
-----------------------------------------------------
City | LINDEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07036-5638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-925-7519
-----------------------------------------------------
Fax | 908-925-2842
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QS0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | 25MA08676900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 25MA08676900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------