Provider Demographics
NPI:1114378718
Name:HUSSAIN, NADIA (MS, RD, CPT)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MS, RD, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WAIPAA LN # 39-202
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2099
Mailing Address - Country:US
Mailing Address - Phone:808-495-3096
Mailing Address - Fax:
Practice Address - Street 1:107 S WALDINGER ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5217
Practice Address - Country:US
Practice Address - Phone:646-361-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1103901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered