MEDICARE: PRABHJOT SINGH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	280378	NY
2	207RC0000X	Cardiovascular Disease Physician	MD204969	OR

General Provider Information

NPI Number	:	1053758490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRABHJOT SINGH MD

Provider Business Mailing Address
First Line	:	20 YORK ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3220
Country	:	US
Telephone Number	:	347-651-5324
Fax Number	:

Provider Business Practice Location Address
First Line	:	19250 SW 65TH AVE
Second Line	:
City	:	TUALATIN
State	:	OR
Zip	:	97062-7452
Country	:	US
Telephone Number	:	503-413-7162
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2013
Last Update Date	:	02/05/2026

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