Provider Demographics
NPI:1033985890
Name:BASSAM HOSSAIN DO PLLC
Entity Type:Organization
Organization Name:BASSAM HOSSAIN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASSAM
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:HOSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-838-9955
Mailing Address - Street 1:8 MOSSHILL PL
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2919
Mailing Address - Country:US
Mailing Address - Phone:516-838-9955
Mailing Address - Fax:
Practice Address - Street 1:8 MOSSHILL PL
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2919
Practice Address - Country:US
Practice Address - Phone:516-838-9955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center