Healthcare Provider Details

I. General information

NPI: 1346703105
Provider Name (Legal Business Name): AWAIS KHAWAR HUSSAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 HAMBURG TPKE STE 202
WAYNE NJ
07470-2166
US

IV. Provider business mailing address

342 HAMBURG TPKE STE 202
WAYNE NJ
07470-2166
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone: 718-200-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA12828800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: