Provider Demographics
NPI:1194257683
Name:SIDDIQUI, FARIHA (MD)
Entity type:Individual
Prefix:
First Name:FARIHA
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LEUNING ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07606-1319
Mailing Address - Country:US
Mailing Address - Phone:201-783-2321
Mailing Address - Fax:
Practice Address - Street 1:659 NEW DOVER RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1912
Practice Address - Country:US
Practice Address - Phone:732-912-7909
Practice Address - Fax:732-515-3373
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA170024207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program