Healthcare Provider Details

I. General information

NPI: 1215962055
Provider Name (Legal Business Name): SYED HOSAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 AMSTERDAM AVE LOWER LEVEL
NEW YORK NY
10031-1716
US

IV. Provider business mailing address

1865 AMSTERDAM AVE LOWER LEVEL
NEW YORK NY
10031-1716
US

V. Phone/Fax

Practice location:
  • Phone: 212-567-5191
  • Fax: 646-843-7669
Mailing address:
  • Phone: 212-567-5191
  • Fax: 646-843-7669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number25MA05994700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number25MA05994700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: