Provider Demographics
NPI:1558941336
Name:SIDDIQUI, UMAMAH SYEDA (DO)
Entity type:Individual
Prefix:
First Name:UMAMAH
Middle Name:SYEDA
Last Name:SIDDIQUI
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:UMAMAH
Other - Middle Name:SYEDA
Other - Last Name:HUSSAINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1859
Mailing Address - Country:US
Mailing Address - Phone:516-572-6637
Mailing Address - Fax:
Practice Address - Street 1:55 MAPLE AVE STE 102
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4267
Practice Address - Country:US
Practice Address - Phone:516-536-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine