| NPI | 1265505036 |
|---|---|
| Former Legal Business Name | SI FAMILY PRACTICE ASSOCIATE |
| Entity Type | Organization |
| Authorized Contact | AZHER SIDDIQI Owner President 718-668-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2014-02-25 |