IV League Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

IV LEAGUE MEDICAL PLLC

Practice address

185 Merritts Rd
Farmingdale, NY 11735-3254

Phone

(516) 595-9264

NPI assigned

Sep 16, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Azmatullah S Hussaini, M.D.NPI 1366725335

Title

President

Phone

(516) 595-9264

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Azmatullah Syed Hussaini, M.D.

  • Internal Medicine Physician
  • Farmingdale, NY
  • NPI 1366725335
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1417679341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MERRITTS RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353254",
            "telephone_number": "516-595-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MERRITTS RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353254",
            "telephone_number": "516-595-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IV LEAGUE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "HUSSAINI",
        "authorized_official_first_name": "AZMATULLAH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-595-9264",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.