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Organization
SI MEDICAL PRACTICE ASSOCIATE PC
Active
Organization
SI MEDICAL PRACTICE ASSOCIATE PC
Active
Other names
SI Family Practice Associate
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AZHER SIDDIQI MD (OWNER PRESIDENT)
(718) 668-2340
Entity
Organization
Contact information
Practice address
1147 RICHMOND ROAD, STATEN ISLAND, NY 10304
(718) 668-2340
(718) 668-2523
Mailing address
1147 RICHMOND ROAD, STATEN ISLAND, NY 10304
(718) 668-2340
(718) 668-2523
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
02/25/2014
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