Provider Demographics
NPI:1407968134
Name:HUSAIN, JAWEED (MD)
Entity Type:Individual
Prefix:DR
First Name:JAWEED
Middle Name:
Last Name:HUSAIN
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 1:196 BEACH 142ND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1250
Mailing Address - Country:US
Mailing Address - Phone:718-283-1900
Mailing Address - Fax:718-635-6745
Practice Address - Street 1:745 64TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4753
Practice Address - Country:US
Practice Address - Phone:718-283-1900
Practice Address - Fax:718-635-6745
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1326422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOTH000Medicare UPIN
NYF37189Medicare UPIN