Provider Demographics
NPI:1700406766
Name:HUSAIN, FARHAN M (MD)
Entity Type:Individual
Prefix:
First Name:FARHAN
Middle Name:M
Last Name:HUSAIN
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 1:101 NICOLLS RD
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, STONY BROOK UNIVERSITY
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:631-444-3005
Mailing Address - Fax:631-444-7534
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, STONY BROOK UNIVERSITY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-3005
Practice Address - Fax:631-444-7534
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2022-08-08
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-08-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program