Basic Information
Provider Information
NPI: 1881764314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUSSAIN
FirstName: SABIHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 66 W GILBERT ST
Address2: 2ND FLOOR
City: TINTON FALLS
State: NJ
PostalCode: 077014947
CountryCode: US
TelephoneNumber: 7322120051
FaxNumber: 7322120713
Practice Location
Address1: 125 PATERSON ST
Address2: CLINICAL ACADEMIC BUILDING - SUITE 5200B
City: NEW BRUNSWICK
State: NJ
PostalCode: 089011962
CountryCode: US
TelephoneNumber: 7322356511
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2006
LastUpdateDate: 07/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMA64615NJN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001X25MA06461500NJY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
000563105NJ MEDICAID


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