Provider Demographics
NPI:1053498949
Name:HUSNI, NICHOLAS R (MD PHD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:R
Last Name:HUSNI
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5005 ROCKSIDE RD
Mailing Address - Street 2:#640
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131
Mailing Address - Country:US
Mailing Address - Phone:216-328-0800
Mailing Address - Fax:216-328-1860
Practice Address - Street 1:29001 CEDAR RD STE 300
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4041
Practice Address - Country:US
Practice Address - Phone:216-264-7800
Practice Address - Fax:216-592-8062
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-085059208200000X
OH35085059208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery