Provider Demographics
NPI:1295777472
Name:HOSTIN, EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:HOSTIN
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 1:3801 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-1119
Mailing Address - Country:US
Mailing Address - Phone:212-249-4240
Mailing Address - Fax:855-693-7089
Practice Address - Street 1:369 LEXINGTON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6536
Practice Address - Country:US
Practice Address - Phone:212-249-4240
Practice Address - Fax:855-693-7089
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225878207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY481F71Medicare ID - Type UnspecifiedBLUE CROSS
NYH76627Medicare UPIN
NY01HCRQMedicare ID - Type UnspecifiedBORO GHI GROUP