Provider Demographics
NPI:1639298672
Name:HUSSAIN, AKHTAR T (OTR)
Entity Type:Individual
Prefix:MR
First Name:AKHTAR
Middle Name:T
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142-BOGERT ROAD
Mailing Address - Street 2:APT 3
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661
Mailing Address - Country:US
Mailing Address - Phone:201-457-3385
Mailing Address - Fax:
Practice Address - Street 1:142 BOGERT RD
Practice Address - Street 2:APT 3
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2048
Practice Address - Country:US
Practice Address - Phone:201-457-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NJ46TR00183300313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility