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General NPI Number Information
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NPI Number | 1699840314
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Entity Type | Individual
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Provider Name | WAQAR AHMED SIDDIQUI MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2371 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314
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Country | US
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Telephone | 718-477-0867
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Fax | 718-477-0891
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Provider Business Mailing Address
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Address Line | 2 TRINITY PLACE
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-494-1770
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Fax | 718-477-0891
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 213527
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | NJ25MA07685700
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License Number State | NJ
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