Healthcare Provider Details

I. General information

NPI: 1437068665
Provider Name (Legal Business Name): MOHAMMED HUSSEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 BROADWAY
ASTORIA NY
11106-3413
US

IV. Provider business mailing address

102 MADISON AVE FL 8
NEW YORK NY
10016-7584
US

V. Phone/Fax

Practice location:
  • Phone: 646-347-0060
  • Fax:
Mailing address:
  • Phone: 212-759-2282
  • Fax: 212-379-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056148
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: