Provider Demographics
NPI:1174045397
Name:EID, HUSSEIN
Entity Type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:
Last Name:EID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-2517
Mailing Address - Country:US
Mailing Address - Phone:201-907-3150
Mailing Address - Fax:
Practice Address - Street 1:219 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-2517
Practice Address - Country:US
Practice Address - Phone:201-907-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293198208100000X
NJ40QA01823300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation