Provider Demographics
NPI:1225204852
Name:HUSAIN, SAJIDAH IJAZ (MD)
Entity type:Individual
Prefix:DR
First Name:SAJIDAH
Middle Name:IJAZ
Last Name:HUSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SHREWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1250
Mailing Address - Country:US
Mailing Address - Phone:732-212-0777
Mailing Address - Fax:
Practice Address - Street 1:211 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1250
Practice Address - Country:US
Practice Address - Phone:732-212-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04517900208000000X
NY246362-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics