Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD056775L | PA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD056775L | PA |
NPI | 1124035233 |
---|---|
Provider Name | Shehla S Siddiqui |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Doylestown, PA 18901-2554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 14/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001715516 | (05) | PA |
8469709 | (05) | NJ |
G84254 | (02) |