Provider Demographics
NPI:1619974466
Name:HUSAR, WALTER GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:GENE
Last Name:HUSAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1005 RAHWAY AVE
Mailing Address - Street 2:UNIT 11
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-2066
Mailing Address - Country:US
Mailing Address - Phone:732-874-5321
Mailing Address - Fax:732-518-5220
Practice Address - Street 1:1005 RAHWAY AVE
Practice Address - Street 2:UNIT 11
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-2066
Practice Address - Country:US
Practice Address - Phone:732-307-5296
Practice Address - Fax:732-518-5220
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA053238002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
083812Medicare ID - Type Unspecified
F36397Medicare UPIN