Healthcare Provider Details

I. General information

NPI: 1972815306
Provider Name (Legal Business Name): GHAZI HUSSAIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CASS AVE
WOONSOCKET RI
02895-4705
US

IV. Provider business mailing address

25 CAPWELL AVE
PAWTUCKET RI
02860-5623
US

V. Phone/Fax

Practice location:
  • Phone: 401-769-4100
  • Fax:
Mailing address:
  • Phone: 401-588-4215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD14298
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number261395
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: