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NPI Code Detail

MEDICARE: ISADIN HUSSEIN

MEDICARE:   ISADIN  HUSSEIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1245945948
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISADIN HUSSEIN
Provider Business Mailing Address
First Line : 8416 XERXES AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55444-1469
Country : US
Telephone Number : 651-493-5102
Fax Number : 651-666-1236
Provider Business Practice Location Address
First Line : 8416 XERXES AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55444-1469
Country : US
Telephone Number : 651-493-5102
Fax Number : 651-666-1236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2023
Last Update Date : 01/17/2023

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