Healthcare Provider Details

I. General information

NPI: 1497334064
Provider Name (Legal Business Name): ANIQA JUNAID ZAIDI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 CHURCHVIEW DR
ROCKFORD IL
61107-2574
US

IV. Provider business mailing address

44 SALLY LN
PLAINVIEW NY
11803-1434
US

V. Phone/Fax

Practice location:
  • Phone: 815-971-8990
  • Fax: 815-971-9978
Mailing address:
  • Phone: 516-439-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: