Provider Demographics
NPI:1821192543
Name:HUSSAIN, SYED S (RPT)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:S
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WOODLAND ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-4318
Mailing Address - Country:US
Mailing Address - Phone:860-527-4321
Mailing Address - Fax:860-527-4323
Practice Address - Street 1:21 WOODLAND ST
Practice Address - Street 2:SUITE 111
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4318
Practice Address - Country:US
Practice Address - Phone:860-527-4321
Practice Address - Fax:860-527-4323
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT51601OtherCIGNA
CT2428472OtherAETNA
CT080005085CT02OtherBLUE CROSS & BLUE SHIELD