Provider Demographics
NPI:1104146323
Name:SADIQ, AZIZ (DO)
Entity type:Individual
Prefix:MR
First Name:AZIZ
Middle Name:
Last Name:SADIQ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 ROUTE 46
Mailing Address - Street 2:STE 212
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:908-992-9724
Mailing Address - Fax:908-850-9174
Practice Address - Street 1:120 CEDAR GROVE LANE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6462
Practice Address - Country:US
Practice Address - Phone:732-307-8886
Practice Address - Fax:732-366-9583
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015927208600000X
NJ25MB09901200208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA231355135OtherEIN