Individual
DR. JOSEPH A SIDAOUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
293644
NY
208D00000X
General Practice Physician
293644
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05178872
—
NY
Enumeration date
06/30/2013
Last updated
09/10/2020
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