Provider Demographics
NPI:1295056216
Name:SYED A HUSSAINI MD INC
Entity type:Organization
Organization Name:SYED A HUSSAINI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUSSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-466-5889
Mailing Address - Street 1:810 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041
Mailing Address - Country:US
Mailing Address - Phone:440-466-5889
Mailing Address - Fax:440-466-5889
Practice Address - Street 1:810 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041
Practice Address - Country:US
Practice Address - Phone:440-466-5889
Practice Address - Fax:440-466-5889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-041030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0338736Medicaid
OH0338736Medicaid