| NPI | 1053444638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL AHMED SIDDIQUI Owner 718-380-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 220368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 221632) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |