Healthcare Provider Details

I. General information

NPI: 1790128866
Provider Name (Legal Business Name): FARAH HUSSAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 04/30/2024
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164TH ST
JAMAICA NY
11432-1121
US

IV. Provider business mailing address

8268 164TH ST STE P113
JAMAICA NY
11432-1121
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3939
  • Fax:
Mailing address:
  • Phone: 718-883-3939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number283776
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: