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General NPI Number Information
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NPI Number | 1750435954
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Entity Type | Organization
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Legal Business Name | ANSLEE, LLC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/01/2011
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Provider Practice Location Address
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Address Line | 24916 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1242
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Country | US
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Telephone | 586-552-8384
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36725
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City | GROSSE POINTE
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State | MI
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Zip | 48236-0725
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Country | US
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Telephone | 586-552-8384
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SAADIA SIDDIQUI
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Credential | M.D.
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Telephone | 586-552-8384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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