Provider Demographics
NPI:1114986072
Name:HUSSAIN, HAMID (MD)
Entity Type:Individual
Prefix:
First Name:HAMID
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BELLE TERRE RD
Mailing Address - Street 2:SUITE: 5
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2500
Mailing Address - Country:US
Mailing Address - Phone:631-476-9736
Mailing Address - Fax:631-476-9738
Practice Address - Street 1:620 BELLE TERRE RD
Practice Address - Street 2:SUITE: 5
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2500
Practice Address - Country:US
Practice Address - Phone:631-476-9736
Practice Address - Fax:631-476-9738
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209477207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1000015694OtherAFFINITY
NY1194854OtherFIRST HEALTH
NY7803105012OtherCIGNA
NY113429351OtherLOACL 1199
NY95G28OtherEMPIRE - ALL PLANS
NY113429351OtherUNITED HEALTHCARE
NY33711POtherHIP
NY50363OtherMDNY
NY113429351OtherISLAND GROUP ADM.
NY2598986OtherGHI
NY01805283Medicaid
NY113429351OtherMAGNACARE
NY113429351OtherMULTIPLAN
NY040426000036OtherFIDELIS
NY113429351OtherHORIZON
NY2038205OtherAETNA HEALTHCARE
NY209477-A10OtherHEALTH FIRST
NY83502OtherVYTRA
NY83502OtherVYTRA
NY7803105012OtherCIGNA