Individual
DR. MUSTAFA M SIDALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
55-59 WASHINGTON AVENUE, BELLEVILLE, NJ 07109
(973) 207-0640
Mailing address
55-59 WASHINGTON AVENUE, BELLEVILLE, NJ 07109
(973) 207-0640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB06569500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7449500
—
NJ
Enumeration date
09/16/2005
Last updated
06/24/2014
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