Basic Information
| Provider Information | |||||||||
| NPI: | 1770019069 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSEIN | ||||||||
| FirstName: | HUSEIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWKINS DR | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522421009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193563435 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2800 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066064201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035766000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2017 | ||||||||
| LastUpdateDate: | 10/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD-47261 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | 67614 | CT | Y | Allopathic & Osteopathic Physicians | General Practice | 2085N0904X | MD-47261 | IA | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 208D00000X | MD-47261 | IA | N | Allopathic & Osteopathic Physicians | General Practice | 390200000X | 68730 | CT | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.