Provider Demographics
NPI:1770271165
Name:PORT JEFFERSON ALLERGY & ASTHMA P.C
Entity type:Organization
Organization Name:PORT JEFFERSON ALLERGY & ASTHMA P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-476-9736
Mailing Address - Street 1:620 BELLE TERRE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2500
Mailing Address - Country:US
Mailing Address - Phone:631-476-9736
Mailing Address - Fax:631-476-9738
Practice Address - Street 1:620 BELLE TERRE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2500
Practice Address - Country:US
Practice Address - Phone:631-476-9736
Practice Address - Fax:631-476-9738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty