Provider Demographics
NPI:1285449231
Name:HOSSAIN, MOHAMMAD NAHID
Entity type:Individual
Prefix:
First Name:MOHAMMAD NAHID
Middle Name:
Last Name:HOSSAIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 ELDERT LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3333
Mailing Address - Country:US
Mailing Address - Phone:914-403-5323
Mailing Address - Fax:
Practice Address - Street 1:3521 12TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2005
Practice Address - Country:US
Practice Address - Phone:914-403-5323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLA-1863085171M00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171M00000XOther Service ProvidersCase Manager/Care Coordinator