Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 248830 | NY |
NPI | 1023202355 |
---|---|
Provider Name | Dr. Jafar Siddiqui |
First Address | Williamsville, NY 14221-7183 |
Second Address | Williamsville, NY 14221-7183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 16/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03116167 | (05) | NY |