Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 042255 | CT |
NPI | 1013990399 |
---|---|
Provider Name | Uzma Dabir Siddiqui |
First Address | New Haven, CT 06510-2715 |
Second Address | New Haven, CT 06510-2715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001422550 | (05) | CT |
112273 | (02) |