North Shore Child Psychiatry PC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

232678 Issued in NY

Legal business name

NORTH SHORE CHILD PSYCHIATRY PC

Practice address

6277 Jericho Tpke
Commack, NY 11725-2837

Phone

(631) 628-6868

Fax

(631) 628-6869

NPI assigned

Jun 14, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Asra F Siddiqi, MDNPI 1013007715

Title

Owner/Operator

Phone

(631) 623-6868

Specialties & licenses 1

Addresses

Other names 1

• ISLAND PSYCHIATRIC CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Asra F Siddiqi, MD

  • Child & Adolescent Psychiatry Physician
  • Commack, NY
  • NPI 1013007715
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1649532797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6277 JERICHO TPKE",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252837",
            "telephone_number": "631-628-6868",
            "fax_number": "631-628-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6277 JERICHO TPKE",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252837",
            "telephone_number": "631-628-6868",
            "fax_number": "631-628-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE CHILD PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "ASRA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "631-623-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "232678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ISLAND PSYCHIATRIC CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ISLAND PSYCHIATRIC CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Niebling, MA, CCC-SLP
• Susan Nissen, PH.D.
• Roseline Codio Noel, RN
• Colleen Noone
• Carol Slingerland Norman, MS CCC SLP
• North Shore Family Acupuncture P.C.
• North Shore Medical Group of the Mount Sinai School of Medicine
• Northshore Biomechanics
• Denise M Novello, M.ED, BCBA, LBA
• Maya Novok, LCSW-R

• Child & Adolescent Psychiatry Physician in Commack, NY
• Providers in Commack, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.