Provider Demographics
NPI:1255657037
Name:HUSSAIN, SYED ASIF (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ASIF
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 1:1053 SHORE PKWY
Mailing Address - Street 2:APT 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3919
Mailing Address - Country:US
Mailing Address - Phone:718-200-7479
Mailing Address - Fax:
Practice Address - Street 1:1053 SHORE PKWY
Practice Address - Street 2:APT 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3919
Practice Address - Country:US
Practice Address - Phone:718-200-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254629208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery