Provider Demographics
NPI:1346797586
Name:HUSSAIN, HUZEFA A (OTR)
Entity Type:Individual
Prefix:MR
First Name:HUZEFA
Middle Name:A
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 IRMA RIVERA WAY
Mailing Address - Street 2:UNIT C.
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-3339
Mailing Address - Country:US
Mailing Address - Phone:201-658-5232
Mailing Address - Fax:
Practice Address - Street 1:3 IRMA RIVERA WAY
Practice Address - Street 2:UNIT C.
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-3339
Practice Address - Country:US
Practice Address - Phone:201-658-5232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00544200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist