Provider Demographics
NPI:1801819255
Name:HOSAIN, HARINI (MD)
Entity Type:Individual
Prefix:
First Name:HARINI
Middle Name:
Last Name:HOSAIN
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 1:701 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE B010
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3080
Mailing Address - Country:US
Mailing Address - Phone:860-286-0041
Mailing Address - Fax:860-243-8601
Practice Address - Street 1:35 JOLLEY DR STE 103
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-4228
Practice Address - Country:US
Practice Address - Phone:860-286-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042489207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010042489CT01OtherANTHEM BLUE SHIELD
2V7493OtherHEALTHNET
CT001424895Medicaid