Healthcare Provider Details

I. General information

NPI: 1942482971
Provider Name (Legal Business Name): SAFIA ANWAR PASHA SIDDIQUI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD STE 3100-E
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

42 E LAUREL RD STE 3100-E
STRATFORD NJ
08084-1354
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-6409
  • Fax: 856-566-6333
Mailing address:
  • Phone: 856-566-7070
  • Fax: 856-566-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD457161
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number25MA09806100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: