Provider Demographics
NPI:1871624098
Name:AL-HUSAINI PLASTIC & RECONSTRUCTIVE SURGERY, P.C.
Entity type:Organization
Organization Name:AL-HUSAINI PLASTIC & RECONSTRUCTIVE SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HIYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-HUSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-776-0505
Mailing Address - Street 1:43 STRATTON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7552
Mailing Address - Country:US
Mailing Address - Phone:914-776-0505
Mailing Address - Fax:
Practice Address - Street 1:955 YONKERS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3060
Practice Address - Country:US
Practice Address - Phone:914-776-0505
Practice Address - Fax:914-713-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215433208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW231Medicare ID - Type Unspecified