1407644677 NPI number — FNU GURJOT SINGH MD

Table of content: FNU GURJOT SINGH MD (NPI 1407644677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407644677 NPI number — FNU GURJOT SINGH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GURJOT SINGH
Provider First Name:
FNU
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1407644677
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
64 ROBBINS STREET, WATERBURY HOSPITAL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATERBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-573-6162
Provider Business Mailing Address Fax Number:
203-573-5707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 ROBBINS STREET, CHASE OUTPATIENT CENTER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATERBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-573-7284
Provider Business Practice Location Address Fax Number:
203-573-7031
Provider Enumeration Date:
04/28/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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