Provider Demographics
NPI:1699911297
Name:SIDDIQUI, DURDANA AAMIR (MD)
Entity type:Individual
Prefix:
First Name:DURDANA
Middle Name:AAMIR
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 1:1925 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401
Mailing Address - Country:US
Mailing Address - Phone:609-441-8146
Mailing Address - Fax:609-441-8002
Practice Address - Street 1:1925 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401
Practice Address - Country:US
Practice Address - Phone:609-441-8146
Practice Address - Fax:609-441-8002
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08504400208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine