Provider Demographics
NPI:1528478963
Name:HUSSAIN, YASMIN (OT)
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 OLD SIB RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2335
Mailing Address - Country:US
Mailing Address - Phone:203-470-5432
Mailing Address - Fax:
Practice Address - Street 1:430 OLD SIB RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2335
Practice Address - Country:US
Practice Address - Phone:203-470-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001210225X00000X
NY002434-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist