Provider Demographics
NPI:1013017284
Name:HUSSAIN, SYED FAIYAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED FAIYAZ
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FAIYAZ
Other - Middle Name:
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:208 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2290
Mailing Address - Country:US
Mailing Address - Phone:732-603-2001
Mailing Address - Fax:
Practice Address - Street 1:208 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2290
Practice Address - Country:US
Practice Address - Phone:732-603-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64277207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7095007Medicaid
NJ7095007Medicaid
NJ892750Medicare PIN
NJG33365Medicare UPIN