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General NPI Number Information
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NPI Number | 1669782439
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Entity Type | Individual
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Provider Name | ELVINA KHUSAINOVA M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 360 W 31ST ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10001-2861
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Country | US
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Telephone | 646-987-3436
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Fax | 646-293-1441
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Provider Business Mailing Address
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Address Line | 700 HICKSVILLE RD STE 205
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City | BETHPAGE
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State | NY
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Zip | 11714-3472
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Country | US
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Telephone |
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Fax |
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 282764
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License Number State | NY
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