Provider Demographics
NPI:1386960136
Name:HUSTON, BRETT J (MD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:J
Last Name:HUSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:435 E 70TH ST
Mailing Address - Street 2:APT. 33J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5342
Mailing Address - Country:US
Mailing Address - Phone:917-685-2501
Mailing Address - Fax:
Practice Address - Street 1:435 E 70TH ST
Practice Address - Street 2:APT. 33J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5342
Practice Address - Country:US
Practice Address - Phone:917-685-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2787762085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging