Provider Demographics
NPI:1346225638
Name:SINGH, DINESH (MD)
Entity type:Individual
Prefix:
First Name:DINESH
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 1:67 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1328
Mailing Address - Country:US
Mailing Address - Phone:203-732-7325
Mailing Address - Fax:
Practice Address - Street 1:300 SEYMOUR AVE STE 202
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1343
Practice Address - Country:US
Practice Address - Phone:203-732-2651
Practice Address - Fax:203-737-4033
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042783208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001427831Medicaid
CT340000368Medicare ID - Type Unspecified
CT001427831Medicaid