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General NPI Number Information
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NPI Number | 1659660942
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Entity Type | Individual
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Provider Name | ASAD RIAZ SIDDIQI D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 515 6TH ST FL 4
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City | BROOKLYN
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State | NY
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Zip | 11215-3608
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Country | US
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Telephone | 646-697-0277
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Fax | 646-967-4265
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Provider Business Mailing Address
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Address Line | 263 7TH AVE STE 5F
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City | BROOKLYN
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State | NY
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Zip | 11215-3690
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Country | US
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Telephone | 646-697-0277
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Fax | 646-967-4265
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 284203
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License Number State | NY
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