Healthcare Provider Details

I. General information

NPI: 1548421191
Provider Name (Legal Business Name): NADEEM I HUSSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 ELMWOOD AVE
BUFFALO NY
14217-1304
US

IV. Provider business mailing address

35 ARCADIAN DR
AMHERST NY
14228-3735
US

V. Phone/Fax

Practice location:
  • Phone: 716-228-2726
  • Fax: 716-447-6755
Mailing address:
  • Phone: 716-228-2726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number277799
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME112791
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: