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General NPI Number Information
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NPI Number | 1235380296
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Entity Type | Individual
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Provider Name | BIMALDEEP K SIDHU M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 8216 PARSONS BLVD 3RD FLOOR
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City | JAMAICA
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State | NY
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Zip | 11432-1047
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Country | US
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Telephone | 646-421-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MARLENE COURT
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City | WOODBRIDGE
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State | ONTARIO
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Zip | L4L8L3
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Country | CA
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Telephone | 416-873-0023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 265083
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License Number State | NY
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