Healthcare Provider Details

I. General information

NPI: 1407788409
Provider Name (Legal Business Name): ARZYUNG SIDDIQUI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15335 79TH AVE
FLUSHING NY
11367-2167
US

IV. Provider business mailing address

15335 79TH AVE
FLUSHING NY
11367-2167
US

V. Phone/Fax

Practice location:
  • Phone: 918-348-9384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP140017
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: