Provider Demographics
NPI:1295824381
Name:HOSSAIN, ASGHAR S (MD)
Entity type:Individual
Prefix:DR
First Name:ASGHAR
Middle Name:S
Last Name:HOSSAIN
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 1:670 YORKTOWN PL
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2208
Mailing Address - Country:US
Mailing Address - Phone:201-652-4045
Mailing Address - Fax:201-652-7233
Practice Address - Street 1:26-01 BROADWAY
Practice Address - Street 2:105
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3861
Practice Address - Country:US
Practice Address - Phone:201-703-3664
Practice Address - Fax:201-652-7233
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA580692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6547800Medicaid
NJ6547800Medicaid
746-796Medicare ID - Type Unspecified