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General NPI Number Information
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NPI Number | 1548591167
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Entity Type | Organization
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Legal Business Name | MOHAMMAD S HUSSAIN MD PC
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 221 BROADWAY SUITE 204
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City | AMITYVILLE
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State | NY
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Zip | 11701-2780
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Country | US
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Telephone | 631-598-4897
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Fax | 631-598-5866
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Provider Business Mailing Address
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Address Line | 221 BROADWAY SUITE 204
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City | AMITYVILLE
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State | NY
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Zip | 11701-2780
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Country | US
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Telephone | 631-598-4897
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Fax | 631-598-5866
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD S HUSSAIN
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Credential | MD
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Telephone | 718-347-0494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 230250
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License Number State | NY
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