Provider Demographics
NPI:1588804884
Name:SLEEP AND WELLNESS MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:SLEEP AND WELLNESS MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOOD
Authorized Official - Middle Name:I
Authorized Official - Last Name:SIDDIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-587-9944
Mailing Address - Street 1:31 E DARRAH LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3763
Mailing Address - Country:US
Mailing Address - Phone:609-587-9944
Mailing Address - Fax:
Practice Address - Street 1:31 E DARRAH LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3763
Practice Address - Country:US
Practice Address - Phone:609-587-9944
Practice Address - Fax:609-587-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty