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General NPI Number Information
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NPI Number | 1619014107
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Entity Type | Individual
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Provider Name | HUSAYN JAWAD AL-HUSAYNI M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE FIRST FLOOR
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-518-5031
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Fax | 718-518-5224
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Provider Business Mailing Address
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Address Line | 2556 82ND ST
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1629
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Country | US
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Telephone | 717-565-5285
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Fax | 718-518-5224
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 208269
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 208269
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License Number State | NY
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