Healthcare Provider Details

I. General information

NPI: 1972036515
Provider Name (Legal Business Name): HUSSEIN SAFA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 W 18TH ST
NEW YORK NY
10011-4401
US

IV. Provider business mailing address

356 W 18TH ST
NEW YORK NY
10011-4401
US

V. Phone/Fax

Practice location:
  • Phone: 212-271-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD470650
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number345593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: