Provider Demographics
NPI:1699755447
Name:HOSSAIN, AFZAL (MD)
Entity type:Individual
Prefix:DR
First Name:AFZAL
Middle Name:
Last Name:HOSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8781 169TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4438
Mailing Address - Country:US
Mailing Address - Phone:718-297-4300
Mailing Address - Fax:718-297-4302
Practice Address - Street 1:8781 169TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4438
Practice Address - Country:US
Practice Address - Phone:718-297-4300
Practice Address - Fax:718-297-4302
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234083207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02603056Medicaid
NY258AD1Medicare ID - Type UnspecifiedEMPIRE