Provider Demographics
NPI:1891338224
Name:HUSSAIN, SYED RASSAL (DMD, MS)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:RASSAL
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SCHUURMAN RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-3223
Mailing Address - Country:US
Mailing Address - Phone:518-892-7103
Mailing Address - Fax:
Practice Address - Street 1:255 SCHUURMAN RD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-3223
Practice Address - Country:US
Practice Address - Phone:518-477-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171651223G0001X
CT143571223X0400X
NY0625041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice