1992796478 NPI number — MOHSIN AKBER HUSAIN MD

Table of content: MOHSIN AKBER HUSAIN MD (NPI 1992796478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992796478 NPI number — MOHSIN AKBER HUSAIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUSAIN
Provider First Name:
MOHSIN
Provider Middle Name:
AKBER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992796478
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8629 SUDLEY RD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
MANASSAS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20110-4590
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-361-3030
Provider Business Mailing Address Fax Number:
703-361-2687

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8629 SUDLEY RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
MANASSAS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20110-4590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-361-3030
Provider Business Practice Location Address Fax Number:
703-361-2687
Provider Enumeration Date:
11/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  11753 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 0101239549 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10258553 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9385116 . This is a "PHHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA32150 . This is a "RIHPILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2102820 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10258707 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10258677 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010258596 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10258715 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7057570 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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