Provider Demographics
NPI:1770543035
Name:AL-HUSAINI, HIYAD JAWAD (MD)
Entity type:Individual
Prefix:DR
First Name:HIYAD
Middle Name:JAWAD
Last Name:AL-HUSAINI
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 1:43 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:914-274-8120
Practice Address - Street 1:130 PONDFIELD RD STE 11
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4016
Practice Address - Country:US
Practice Address - Phone:914-776-0505
Practice Address - Fax:914-274-8120
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215433208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02203469Medicaid
H50113Medicare UPIN
NY02203469Medicaid