# JAVED ILYAS SIDDIQI, M.D. LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JAVED I SIDDIQI, M.D.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225587108
- **Legal business name:** JAVED I SIDDIQI, M.D.
- **Authorized official:** JOAN CAMPBELL (BILLING MANAGER)
- **Authorized official phone:** (978) 244-0019

## Contact information

- **Practice address:** 380 MERRIMACK ST, SUITE 2C, METHUEN, MA 01844-5870
- **Practice address phone:** (978) 689-0033
- **Practice address fax:** (978) 682-0033
- **Mailing address:** 380 MERRIMACK ST, SUITE 2C, METHUEN, MA 01844-5870
- **Mailing address phone:** (978) 689-0033
- **Mailing address fax:** (978) 682-0033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 56836 | MA | Yes |

## Other

- **Enumeration date:** 10/03/2016
- **Last updated:** 01/03/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110043613A | — | MA |