Individual
AYESHA SUNDUS SIDDIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 WAWECUS ST, NORWICH, CT 06360-2162
(860) 972-6113
Mailing address
11 SAGAMORE LN UNIT 108, ROCKY HILL, CT 06067-3847
(401) 441-9734
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
67089
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2017
Last updated
07/13/2022
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