Healthcare Provider Details

I. General information

NPI: 1396083481
Provider Name (Legal Business Name): MISBAHUL HAFEEZ SIDDIQI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S 5TH AVE
READING PA
19611-2143
US

IV. Provider business mailing address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-5455
  • Fax: 484-628-5772
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD492579
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: