Provider Demographics
NPI:1154462513
Name:HUSSAIN, KASHIF (MD)
Entity Type:Individual
Prefix:
First Name:KASHIF
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 1:325 MEETING HOUSE LN STE 302
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-7000
Mailing Address - Country:US
Mailing Address - Phone:631-283-8008
Mailing Address - Fax:
Practice Address - Street 1:325 MEETING HOUSE LN STE 302
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-7000
Practice Address - Country:US
Practice Address - Phone:631-283-8008
Practice Address - Fax:631-283-8870
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY289120207R00000X
WV24577207RC0200X
NH13376207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207189Medicaid
MO209000801Medicaid
MOH86333Medicare UPIN
NH30207189Medicaid