Provider Demographics
NPI:1073017588
Name:HUSSAIN, BILAL (PHARM D)
Entity type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PEARL ST APT 809
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-2442
Mailing Address - Country:US
Mailing Address - Phone:708-662-0001
Mailing Address - Fax:
Practice Address - Street 1:713 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3969
Practice Address - Country:US
Practice Address - Phone:860-224-3494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051298365183500000X
CTPCT.0014747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist