Provider Demographics
NPI:1912947508
Name:AHMAD, HUSSEIN (PT)
Entity Type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 N BROADWAY
Mailing Address - Street 2:G-02
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1304
Mailing Address - Country:US
Mailing Address - Phone:914-375-5605
Mailing Address - Fax:914-375-5405
Practice Address - Street 1:944 N BROADWAY
Practice Address - Street 2:G-02
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1304
Practice Address - Country:US
Practice Address - Phone:914-375-5605
Practice Address - Fax:914-375-5405
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ08L0QQ351Medicare PIN