Provider Demographics
NPI:1306968417
Name:SINGH, MARVIN (MD)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HAGEN DR STE 330
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2664
Mailing Address - Country:US
Mailing Address - Phone:585-267-4040
Mailing Address - Fax:585-267-4044
Practice Address - Street 1:20 HAGEN DR STE 330
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2664
Practice Address - Country:US
Practice Address - Phone:585-267-4040
Practice Address - Fax:585-267-4044
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102749207RG0100X
NY265559207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010964600Medicaid
CA1306968417Medicaid
NY03474691Medicaid
FL14W3VOtherFLORIDA BLUE