Provider Demographics
NPI:1083819411
Name:HUSAIN, SYED ASIM (DO)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ASIM
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 LAMBERTS LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7210
Mailing Address - Country:US
Mailing Address - Phone:718-477-5479
Mailing Address - Fax:718-761-1770
Practice Address - Street 1:82 LAMBERTS LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314
Practice Address - Country:US
Practice Address - Phone:718-477-5479
Practice Address - Fax:718-761-1770
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255539208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03343419Medicaid
NY03343419Medicaid