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General NPI Number Information
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NPI Number | 1952397697
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Entity Type | Individual
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Provider Name | DEEBA HUSAIN MD
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 243 CHARLES ST 12TH FLOOR
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City | BOSTON
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State | MA
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Zip | 02114-3002
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Country | US
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Telephone | 671-573-4074
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Fax | 617-573-3631
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Provider Business Mailing Address
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Address Line | 243 CHARLES STREET RETINA SERVICE, MEEI
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City | BOSTON
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State | MA
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Zip | 02114-3096
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Country | US
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Telephone | 617-573-4074
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 203366
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License Number State | MA
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