Provider Demographics
NPI:1134197346
Name:HUSAIN, SALEEM (MD)
Entity type:Individual
Prefix:
First Name:SALEEM
Middle Name:
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 1:1314 PARK AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3253
Mailing Address - Country:US
Mailing Address - Phone:908-222-8970
Mailing Address - Fax:908-222-8762
Practice Address - Street 1:1314 PARK AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3253
Practice Address - Country:US
Practice Address - Phone:908-222-8970
Practice Address - Fax:908-222-8762
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA058027207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7019301Medicaid
NJ626607Medicare PIN
F99631Medicare UPIN