Provider Demographics
NPI:1649288234
Name:HOSAIN, ROMANA IQBAL (MD)
Entity type:Individual
Prefix:
First Name:ROMANA
Middle Name:IQBAL
Last Name:HOSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 NORTH STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-565-5437
Mailing Address - Fax:845-565-7021
Practice Address - Street 1:266 NORTH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-565-5437
Practice Address - Fax:845-565-7021
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2232451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02250159Medicaid