Healthcare Provider Details

I. General information

NPI: 1033798210
Provider Name (Legal Business Name): MUHAMMAD ASAD SIDDIQUE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 3RD AVE
NEW YORK NY
10016-6021
US

IV. Provider business mailing address

193 PEMBROKE ST
BROOKLYN NY
11235-2312
US

V. Phone/Fax

Practice location:
  • Phone: 646-537-1117
  • Fax:
Mailing address:
  • Phone: 929-434-8488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04160200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number069582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: