Healthcare Provider Details

I. General information

NPI: 1780672188
Provider Name (Legal Business Name): SAJJAD HUSSAIN MEDICAL DOCTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 LACEY RD STE G-07
FORKED RIVER NJ
08731-1300
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 609-339-2003
  • Fax: 609-339-2016
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25MA066885500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: