Provider Demographics
NPI:1255205993
Name:SIDDIQUI, LILY
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:SIDDIQUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 CONEY ISLAND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6244
Mailing Address - Country:US
Mailing Address - Phone:718-975-8282
Mailing Address - Fax:347-627-9261
Practice Address - Street 1:3140 CONEY ISLAND AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6244
Practice Address - Country:US
Practice Address - Phone:718-975-8282
Practice Address - Fax:347-627-9261
Is Sole Proprietor?:No
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care