Healthcare Provider Details

I. General information

NPI: 1427739028
Provider Name (Legal Business Name): MOHAMAD HOSNI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COMMUNITY DR
GREAT NECK NY
11021-5501
US

IV. Provider business mailing address

8331 TOWN BROOKE
MIDDLETOWN CT
06457-6622
US

V. Phone/Fax

Practice location:
  • Phone: 516-465-8200
  • Fax:
Mailing address:
  • Phone: 305-645-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number78613
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number342938
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number38675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: