Organization
BAYONNE MEDICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMAD SIDDIQUE M.D. (PRESIDENT)
(732) 750-1180
Entity
Organization
Contact information
Practice address
415 AVENEL ST, AVENEL, NJ 07001-1147
(732) 750-1180
(732) 750-1182
Mailing address
415 AVENEL ST, AVENEL, NJ 07001-1147
(732) 750-1180
(732) 750-1182
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA 67664
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7797001
—
NJ
Enumeration date
08/26/2009
Last updated
07/24/2012
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