Healthcare Provider Details

I. General information

NPI: 1124144522
Provider Name (Legal Business Name): ZAKARIA SIDDIQUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 S 17TH ST SUITE 202
LINCOLN NE
68502-3700
US

IV. Provider business mailing address

2222 S 16TH ST SUITE 400A
LINCOLN NE
68502-3796
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8555
  • Fax: 402-483-8554
Mailing address:
  • Phone: 402-483-8590
  • Fax: 402-483-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22615
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: