NPI 1225698202 · live from the CMS NPI Registry
Sidra Anis
Physician Assistant, Medical in Bayonne, NJ. National Provider Identifier 1225698202, active.
NPI record
| NPI | 1225698202 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 904 Bayonne Crossing Way, Bayonne, NJ 07002 |
| Practice phone | 551-497-5675 |
| Mailing address | 1 Diamond Hill Rd, Berkeley Heights, NJ 07922 |
| Enumerated | June 20, 2019 |
| Last updated | September 29, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | — |
| Physician Assistant, Medical primary | 363AM0700X | 25MP00645300 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.