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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