Provider Demographics
NPI:1588864078
Name:HUSAIN, TAHERA (MD)
Entity type:Individual
Prefix:DR
First Name:TAHERA
Middle Name:
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 1:11 ZEV CT
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3105
Mailing Address - Country:US
Mailing Address - Phone:732-297-7152
Mailing Address - Fax:718-282-5152
Practice Address - Street 1:11 ZEV CT
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-3105
Practice Address - Country:US
Practice Address - Phone:732-297-7152
Practice Address - Fax:718-282-5152
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ055960207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ688983Medicare PIN
B18621Medicare UPIN