Javed Ilyas Siddiqi, M.D. LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

56836 Issued in MA

Legal business name

JAVED ILYAS SIDDIQI, M.D. LLC

Practice address

380 Merrimack St
Suite 2C
Methuen, MA 01844-5870

Phone

(978) 689-0033

Fax

(978) 682-0033

NPI assigned

Oct 3, 2016

Organization subpart

Yes

Parent organization

JAVED I SIDDIQI, M.D.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joan Campbell

Title

Billing Manager

Phone

(978) 244-0019

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Javed Ilyas Siddiqi MD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1225587108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 2C",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-689-0033",
            "fax_number": "978-682-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 2C",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-689-0033",
            "fax_number": "978-682-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVED ILYAS SIDDIQI, M.D. LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAVED I SIDDIQI, M.D.",
        "enumeration_date": "2016-10-03",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "978-244-0019"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "56836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110043613A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orathai Jaisom, RN
• Jillian Jalbert
• Carolina Jaldin
• Jeffrey Henry Janco, CNP
• Kathleen Mary Jarmolowicz, RN
• Vickibelle Javier
• Sophie Jean-Francois
• Kissinger Jean-Poix, REGISTER NURSE
• Sung Bae Jee, M.D.
• Katherine Jellison, LICSW

• Obstetrics & Gynecology Physician in Methuen, MA
• Providers in Methuen, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.