Provider Demographics
NPI:1467770925
Name:HUSSAIN, HAFIZ GHULAM (MD)
Entity Type:Individual
Prefix:
First Name:HAFIZ
Middle Name:GHULAM
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 1:2553 WILLIAMSBRIDGE RD
Mailing Address - Street 2:APT#3
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4352
Mailing Address - Country:US
Mailing Address - Phone:516-605-4956
Mailing Address - Fax:
Practice Address - Street 1:2553 WILLIAMSBRIDGE RD
Practice Address - Street 2:APT#3
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4352
Practice Address - Country:US
Practice Address - Phone:516-605-4956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-08
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277912207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease