Provider Demographics
NPI:1528733516
Name:SINGH, ANMOL
Entity type:Individual
Prefix:
First Name:ANMOL
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 STRATTON LN
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2550
Mailing Address - Country:US
Mailing Address - Phone:856-401-0118
Mailing Address - Fax:
Practice Address - Street 1:141 TUCKAHOE RD STE 460
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-3845
Practice Address - Country:US
Practice Address - Phone:856-237-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00708600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist