Provider Demographics
NPI:1053397620
Name:SADIQ, RIFFAT (MD)
Entity type:Individual
Prefix:
First Name:RIFFAT
Middle Name:
Last Name:SADIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4979 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2547
Mailing Address - Country:US
Mailing Address - Phone:716-923-4390
Mailing Address - Fax:716-923-4384
Practice Address - Street 1:4979 HARLEM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2547
Practice Address - Country:US
Practice Address - Phone:716-923-4380
Practice Address - Fax:716-923-4384
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000525801004OtherBC/BS
NY0111431OtherINDEPENDENT HEALTH
NY00020552704OtherUNIVERA
NY0110827OtherIHA
NY01958534Medicaid
NY0404260024961OtherFIDELIS
NY241494OtherWELLCARE
NY00030546405OtherUNIVERA
NY000525801006OtherBC/BS
NY000525801007OtherBC/BS
NY061010000022OtherFIDELIS
NY480245OtherWELLCARE
NY151115BJOtherPREFERRED CARE
NY480249OtherWELLCARE
NY151115BJOtherPREFERRED CARE
NY480245OtherWELLCARE
NY01958534Medicaid
NYDD3590Medicare PIN