Provider Demographics
NPI:1578740197
Name:SIDDIQUI, ZEHRA (DO)
Entity Type:Individual
Prefix:DR
First Name:ZEHRA
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PERRINE RD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2842
Mailing Address - Country:US
Mailing Address - Phone:732-727-8800
Mailing Address - Fax:732-727-0955
Practice Address - Street 1:200 PERRINE RD
Practice Address - Street 2:SUITE 229
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2842
Practice Address - Country:US
Practice Address - Phone:732-727-8800
Practice Address - Fax:732-727-0955
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB077291002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MB07729100OtherLICENSE
NJBS9162417OtherDEA