Healthcare Provider Details

I. General information

NPI: 1568302834
Provider Name (Legal Business Name): MARIA SADDIQUE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2334 E 28TH ST
BROOKLYN NY
11229-5034
US

IV. Provider business mailing address

376 VANDERBILT AVE
STATEN ISLAND NY
10304-3508
US

V. Phone/Fax

Practice location:
  • Phone: 646-431-9296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: