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General NPI Number Information
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NPI Number | 1427188630
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Entity Type | Individual
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Provider Name | BUSHRA SIDDIQUI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 201 E 104TH ST
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City | NEW YORK
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State | NY
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Zip | 10029-5418
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Country | US
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Telephone | 212-348-5492
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MAIN ST STE 201
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2614
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Country | US
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Telephone | 914-997-9000
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Fax | 914-428-6537
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DIO2312400
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License Number State | NJ
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