Healthcare Provider Details

I. General information

NPI: 1619974466
Provider Name (Legal Business Name): WALTER GENE HUSAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SNOWHILL ST
SPOTSWOOD NJ
08884-1358
US

IV. Provider business mailing address

3308 CEDAR VILLAGE BLVD
EAST BRUNSWICK NJ
08816-1388
US

V. Phone/Fax

Practice location:
  • Phone: 732-690-2875
  • Fax: 732-518-5220
Mailing address:
  • Phone: 732-690-0875
  • Fax: 732-518-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA05323800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: