MEDICARE: DR. SYED ASIF HUSSAIN M.D.

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
1	208600000X	Surgery Physician	254629	NY

General Provider Information

NPI Number	:	1255657037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED ASIF HUSSAIN M.D.

Provider Business Mailing Address
First Line	:	1053 SHORE PKWY
Second Line	:	APT 2B
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3919
Country	:	US
Telephone Number	:	718-200-7479
Fax Number	:

Provider Business Practice Location Address
First Line	:	1053 SHORE PKWY
Second Line	:	APT 2B
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3919
Country	:	US
Telephone Number	:	718-200-7479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	12/17/2012

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