Provider Demographics
NPI:1417129818
Name:HUSNE, FERDOUS (D,DS)
Entity Type:Individual
Prefix:DR
First Name:FERDOUS
Middle Name:
Last Name:HUSNE
Suffix:
Gender:F
Credentials:D,DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8146 BAXTER AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1336
Mailing Address - Country:US
Mailing Address - Phone:718-478-1710
Mailing Address - Fax:
Practice Address - Street 1:8146 BAXTER AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1336
Practice Address - Country:US
Practice Address - Phone:718-478-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044973122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01471750Medicaid