Organization
SIDDIQUI MD & ASSOCIATES PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NASIRUDDIN A SIDDIQUI M.D. (OWNER)
(502) 394-0402
Entity
Organization
Contact information
Practice address
8011 NEW LAGRANGE RD, SUITE 1, LOUISVILLE, KY 40222-4781
(502) 394-0402
(502) 394-0480
Mailing address
8011 NEW LAGRANGE RD, SUITE 1, LOUISVILLE, KY 40222-4781
(502) 394-0402
(502) 394-0480
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
24221
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64242217
—
KY
Enumeration date
03/19/2008
Last updated
06/30/2015
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