Cathedral Ledge Aesthetics and Wellness
Organization Active NPI General Practice Physician · Conway, NH
NPI 1083487599 · NPPES record last updated Jul 10, 2026
Key facts
- NPI
- 1083487599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- CATHEDRAL LEDGE AESTHETICS AND WELLNESS
- Practice address
- 53 Technology LN Ste 105
Conway, NH 03818-0299 - Phone
- (603) 662-2557
- NPI assigned
- Nov 6, 2023
- Organization subpart
- No
Authorized official
- Name
- Sohaib Siddiqui
- Title
- Owner
- Phone
- (603) 662-2557
Practitioners 1
-
Sohaib Siddiqui, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231212002098 | NH | Part B Supplier - Clinic/Group Practice | 5193174472 |
Receives reassigned benefits from 1 practitioner Practice locations: Conway, NH |
National Provider Directory
Locations
53 Technology Ln
Ste 105
Conway, NH 03818
Phone (603) 387-4523
1857 White Mountain Hwy
Unit 1
North Conway, NH 03860
Phone (603) 662-2557
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
53 Technology LN Ste 105
Conway, NH 03818-0299
Mailing address
PO Box 308
Conway, NH 03818-0308
Phone (603) 662-2557
Other providers in Conway, NH
- Bruce D. Latham, D.O.,P.a.
- Karen Kilegle Buchanana
- Lauren Campbell
- Michael Francis Campbell
- Jamie Carrier
- Valeda Cerasale
- Lani Chandler
- Mark R Chaput
- Martin Leo Chaput
- Henry G. Cheney Jr.
All providers in Conway, NH · General Practice Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.