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General NPI Number Information
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NPI Number | 1508177650
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Entity Type | Organization
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Legal Business Name | ENCOMPASS MEDICAL DIAGNOSTICS, P.C.
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 10114 LIBERTY AVE
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City | OZONE PARK
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State | NY
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Zip | 11417-1725
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Country | US
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Telephone | 516-256-2017
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Fax | 516-256-2029
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Provider Business Mailing Address
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Address Line | 10114 LIBERTY AVE
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City | OZONE PARK
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State | NY
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Zip | 11417-1725
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Country | US
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Telephone | 516-256-2017
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Fax | 516-256-2029
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAEED A SIDDIQUI
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Credential | M.D.
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Telephone | 516-256-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 213042
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License Number State | NY
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