Provider Demographics
NPI:1871640599
Name:HUSSAIN, ZAKIR (MD)
Entity Type:Individual
Prefix:MR
First Name:ZAKIR
Middle Name:
Last Name:HUSSAIN
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 1:3183 ROCHAMBEAU AVE
Mailing Address - Street 2:APT. 2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3754
Mailing Address - Country:US
Mailing Address - Phone:347-707-3016
Mailing Address - Fax:
Practice Address - Street 1:54 WILLOW ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-2084
Practice Address - Country:US
Practice Address - Phone:603-752-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13772207Q00000X
NHLT-2533174400000X
NY278742-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206612Medicaid
NH30206612Medicaid
RE9020Medicare PIN