Provider Demographics
NPI:1942212774
Name:HUSSAIN, ASHFAQ SWAPAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHFAQ
Middle Name:SWAPAN
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18 FIELDHOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1038
Mailing Address - Country:US
Mailing Address - Phone:631-456-4447
Mailing Address - Fax:561-282-3233
Practice Address - Street 1:4 TECHNOLOGY DRIVE
Practice Address - Street 2:SUITE-130
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733
Practice Address - Country:US
Practice Address - Phone:631-675-2555
Practice Address - Fax:631-331-1932
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197431207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1091809OtherUNITED HEALTHCARE
NY390005378OtherRAILROAD MEDICARE
NY82142OtherVYTRA
NYP4115302OtherOXFORD
NY01548172Medicaid
NY5497732OtherAETNA
NY7X4431OtherEMPIRE BCBS
NYPRV0004590OtherMONTEFIORE
NY4752605008OtherCIGNA
NY5497732OtherAETNA
NYA400030778Medicare PIN