Provider Demographics
NPI:1215962055
Name:HOSAIN, SYED (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:HOSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 AMSTERDAM AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-1716
Mailing Address - Country:US
Mailing Address - Phone:212-567-5191
Mailing Address - Fax:646-843-7669
Practice Address - Street 1:1865 AMSTERDAM AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1716
Practice Address - Country:US
Practice Address - Phone:212-567-5191
Practice Address - Fax:646-843-7669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA059947002084N0402X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7261608Medicaid
NJ7261608Medicaid
G46396Medicare UPIN
G46396Medicare UPIN