Provider Demographics
NPI:1629452164
Name:HOSSAIN, SM GULZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SM
Middle Name:GULZAR
Last Name:HOSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:S M
Other - Middle Name:GULZAR
Other - Last Name:HOSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD,
Mailing Address - Street 1:850 MONROE ST APT 1
Mailing Address - Street 2:850 MONROE STREET APT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-4181
Mailing Address - Country:US
Mailing Address - Phone:646-642-6204
Mailing Address - Fax:347-405-6289
Practice Address - Street 1:850 MONROE STREET. APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221
Practice Address - Country:US
Practice Address - Phone:646-642-6204
Practice Address - Fax:347-405-6289
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP96729213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery