Provider Demographics
NPI:1972619013
Name:SINGH, JAGMOHAN (MD)
Entity type:Individual
Prefix:
First Name:JAGMOHAN
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 1:220 STEUBEN ST
Mailing Address - Street 2:
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-9740
Mailing Address - Country:US
Mailing Address - Phone:607-535-8639
Mailing Address - Fax:607-535-4433
Practice Address - Street 1:230 STEUBEN STREET
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865
Practice Address - Country:US
Practice Address - Phone:607-535-7154
Practice Address - Fax:607-535-7157
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178890207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01390165Medicaid
NY204480114OtherBLUE CROSS
F50354Medicare UPIN