Provider Demographics
NPI:1033798210
Name:SIDDIQUE, MUHAMMAD ASAD (RPH)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ASAD
Last Name:SIDDIQUE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BRIGHTON 4TH TER APT 2F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6719
Mailing Address - Country:US
Mailing Address - Phone:929-461-4357
Mailing Address - Fax:
Practice Address - Street 1:170 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3740
Practice Address - Country:US
Practice Address - Phone:718-946-0101
Practice Address - Fax:718-946-7511
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04160200183500000X
NY069582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist