Healthcare Provider Details

I. General information

NPI: 1316928450
Provider Name (Legal Business Name): ASMA J SADIQ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 04/16/2024
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E. PALISADES AVENUE SUITE A4
ENGLEWOOD CLIFFS NJ
07632
US

IV. Provider business mailing address

661 E. PALISADES AVENUE SUITE A4
ENGLEWOOD CLIFFS NJ
07632
US

V. Phone/Fax

Practice location:
  • Phone: 201-408-4777
  • Fax: 201-408-4661
Mailing address:
  • Phone: 201-408-4777
  • Fax: 201-408-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number178809
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number25MA05751400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number178809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: