1114986072 NPI number — HAMID HUSSAIN M.D.

Table of content: HAMID HUSSAIN M.D. (NPI 1114986072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114986072 NPI number — HAMID HUSSAIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUSSAIN
Provider First Name:
HAMID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1114986072
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 BELLE TERRE RD
Provider Second Line Business Mailing Address:
SUITE: 5
Provider Business Mailing Address City Name:
PORT JEFFERSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11777-2500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-476-9736
Provider Business Mailing Address Fax Number:
631-476-9738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 BELLE TERRE RD
Provider Second Line Business Practice Location Address:
SUITE: 5
Provider Business Practice Location Address City Name:
PORT JEFFERSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11777-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-476-9736
Provider Business Practice Location Address Fax Number:
631-476-9738
Provider Enumeration Date:
03/20/2006

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: 207K00000X , with the licence number:  209477 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1000015694 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1194854 . This is a "FIRST HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7803105012 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113429351 . This is a "LOACL 1199" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 95G28 . This is a "EMPIRE - ALL PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113429351 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 33711P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 50363 . This is a "MDNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113429351 . This is a "ISLAND GROUP ADM." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2598986 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01805283 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113429351 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113429351 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040426000036 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113429351 . This is a "HORIZON" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2038205 . This is a "AETNA HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 209477-A10 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 83502 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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