Healthcare Provider Details
I. General information
NPI: 1598184756
Provider Name (Legal Business Name): MUNIF HUSSAIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/15/2014
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
657 CENTRAL AVE
CEDARHURST NY
11516-2320
US
IV. Provider business mailing address
230 NEW HYDE PARK RD
GARDEN CITY NY
11530-2324
US
V. Phone/Fax
- Phone: 516-295-0111
- Fax: 516-295-9438
- Phone: 347-512-6232
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PS0010X |
| Taxonomy | Sports Medicine (Emergency Medicine) Physician |
| License Number | 286419 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 286419 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 286419 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: