Healthcare Provider Details

I. General information

NPI: 1528380284
Provider Name (Legal Business Name): SALMAN ANIS SIDDIQUI PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 MAIN ST
SOUTH FARMINGDALE NY
11735-5426
US

IV. Provider business mailing address

2199 JACKSON PL
NORTH BELLMORE NY
11710-1104
US

V. Phone/Fax

Practice location:
  • Phone: 516-845-5235
  • Fax:
Mailing address:
  • Phone: 516-785-4817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53880
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: