Siddiqui, Imtiazuddin M

Siddiqui, Imtiazuddin M is an individual health care provider with primary practice located at 510 Hamburg Turnpike Suite E106, Wayne NJ 07470. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Siddiqui, Imtiazuddin M can be contacted via phone (973) 904-3161.

Contact Information

Primary practice address
510 Hamburg Turnpike Suite E106 Wayne NJ 07470
Fax: (973) 904-3168
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MA041078 New Jersey

Profile Details

NPI number 1851477186
LBN Legal business name Siddiqui, Imtiazuddin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2006
Last updated Mar 27th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851477186 NPPES
New Jersey MEDICAID 7833008

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