Organization
GENESEE STREET MEDICAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MINHAJ U SIDDIQI MD (OWNER/ PROVIDER)
(315) 335-4619
Entity
Organization
Contact information
Practice address
286 GENESEE ST STE 5, UTICA, NY 13502
(315) 266-0600
(315) 266-0611
Mailing address
286 GENESEE ST STE 5, UTICA, NY 13502-4639
(315) 266-0600
(315) 266-0611
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
232467
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04989199
—
NY
Enumeration date
11/28/2017
Last updated
08/09/2018
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