Healthcare Provider Details

I. General information

NPI: 1134197346
Provider Name (Legal Business Name): SALEEM HUSAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 PARK AVE SUITE 9
PLAINFIELD NJ
07060-3253
US

IV. Provider business mailing address

1314 PARK AVE SUITE 9
PLAINFIELD NJ
07060-3253
US

V. Phone/Fax

Practice location:
  • Phone: 908-222-8970
  • Fax: 908-222-8762
Mailing address:
  • Phone: 908-222-8970
  • Fax: 908-222-8762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA058027
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA058027
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: