Provider Demographics
NPI:1538596804
Name:SINGH, MALINI S (DPM)
Entity type:Individual
Prefix:DR
First Name:MALINI
Middle Name:S
Last Name:SINGH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5669
Mailing Address - Country:US
Mailing Address - Phone:856-296-5690
Mailing Address - Fax:
Practice Address - Street 1:432 OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5669
Practice Address - Country:US
Practice Address - Phone:856-296-5690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00279400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJV02559Medicare UPIN
NJ086064TJQMedicare PIN