Basic Information
| Provider Information | |||||||||
| NPI: | 1306012000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SADIQ | ||||||||
| FirstName: | ADNAN | ||||||||
| MiddleName: | SUHAEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 144 MORGAN ST | ||||||||
| Address2: | STE 8 | ||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069055433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144004227 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 144 MORGAN ST | ||||||||
| Address2: | STE 8 | ||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069055433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037568021 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2008 | ||||||||
| LastUpdateDate: | 01/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 046590 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.