Individual
MR. YUSUF MOHAMED SIDDIQUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
2178 MAIN ST, BUFFALO, NY 14214-2634
(716) 838-8488
(716) 838-3022
Mailing address
2178 MAIN ST, BUFFALO, NY 14214-2634
(716) 838-8488
(716) 838-3022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
136544
NY
208600000X
Surgery Physician
35630
MO
208D00000X
General Practice Physician
136544
NY
208D00000X
General Practice Physician
35630
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000508766003
CB BLUE CROSS
—
01
—
0010165801
UNIVERA
—
05
—
00746901
—
NY
Enumeration date
01/24/2007
Last updated
03/08/2012
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