Organization
SIDAOUI CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH SIDAOUI MD (PRESIDENT)
(407) 446-3323
Entity
Organization
Contact information
Practice address
27 KINGSLAND AVE APT 2L, BROOKLYN, NY 11211-1551
(407) 446-3323
Mailing address
27 KINGSLAND AVE APT 2L, BROOKLYN, NY 11211-1551
(407) 446-3323
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293644
MEDICAL LIC
NY
Enumeration date
01/21/2020
Last updated
09/10/2020
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