Provider Demographics
NPI:1801134119
Name:HUSSAIN, SARAH (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:HUSSAIN
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 1:115 OLD SHORT HILLS RD
Mailing Address - Street 2:APPT 295
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1009
Mailing Address - Country:US
Mailing Address - Phone:631-456-6394
Mailing Address - Fax:
Practice Address - Street 1:22 OLD SHORT HILLS ROAD
Practice Address - Street 2:SUIT 104
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1009
Practice Address - Country:US
Practice Address - Phone:973-535-9682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MA09352400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine