MEDICARE: DR. QUDSIA HUSAIN DDS

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	1223P0221X	Pediatric Dentistry	054231	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265630446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUDSIA HUSAIN DDS

Provider Business Mailing Address
First Line	:	45 RIVER DR S
Second Line	:	APT 2410
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-1741
Country	:	US
Telephone Number	:	571-723-9992
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 RIVER DR S
Second Line	:	APT 2410
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-1741
Country	:	US
Telephone Number	:	571-723-9992
Fax Number	:

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	11/16/2016

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