Basic Information
| Provider Information | |||||||||
| NPI: | 1689847709 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSSAIN | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | ATIF | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 UNIVERSITY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157107037 | ||||||||
| FaxNumber: | 2157105181 | ||||||||
| Practice Location | |||||||||
| Address1: | 1203 LANGHORNE NEWTOWN RD | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | LANGHORNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190471209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2147507818 | ||||||||
| FaxNumber: | 2157520436 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2008 | ||||||||
| LastUpdateDate: | 05/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD436928 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | MD436928 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 30203502 | 01 | PA | KEYSTONE FIRST | OTHER | 1023244680003 | 05 | PA | MEDICAID | 9705365 | 01 | PA | AETNA | OTHER | 7911855 | 01 | PA | CIGNA PA | OTHER | 3717070000 | 01 | PA | KEYSTONE IBC | OTHER | 2102017 | 01 | PA | HIGHMARK BLUE CORSS BLUE SHIELD | OTHER | P01193851 | 01 | PA | RAILROAD MEDICARE | OTHER |