Healthcare Provider Details

I. General information

NPI: 1255590113
Provider Name (Legal Business Name): SHAFINAZ HUSSEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

1468 MADISON AVENUE ANNENBERG 15-76C
NEW YORK NY
10029-6574
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-5082
  • Fax:
Mailing address:
  • Phone: 212-241-5082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number261415
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: