1669704094 NPI number — KULDEEP SINGH MD,LLC

Table of content: (NPI 1669704094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669704094 NPI number — KULDEEP SINGH MD,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KULDEEP SINGH MD,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QUICK MED
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669704094
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
339 VILLAGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROADVIEW HTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44147-3474
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-582-1597
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4804 PEARL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44109-5144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-582-1597
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SINGH
Authorized Official First Name:
KULDEEP
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
440-582-1597

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  35-100208 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0322912 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com