Provider Demographics
NPI:1649579814
Name:HUSSAIN, BENISH (MD)
Entity Type:Individual
Prefix:
First Name:BENISH
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1254
Mailing Address - Country:US
Mailing Address - Phone:203-271-2120
Mailing Address - Fax:203-272-3197
Practice Address - Street 1:1781 HIGHLAND AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1254
Practice Address - Country:US
Practice Address - Phone:203-271-2120
Practice Address - Fax:203-272-3197
Is Sole Proprietor?:No
Enumeration Date:2011-03-27
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT050134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine