Provider Demographics
NPI:1275795387
Name:HUSAIN, ASRA (DO)
Entity Type:Individual
Prefix:DR
First Name:ASRA
Middle Name:
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2135
Mailing Address - Country:US
Mailing Address - Phone:516-823-0316
Mailing Address - Fax:
Practice Address - Street 1:1129 LINDEN ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2135
Practice Address - Country:US
Practice Address - Phone:516-823-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361661142084N0400X
NY2662312084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty