Provider Demographics
NPI:1215220405
Name:LATEFI, AHMAD (DO)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:LATEFI
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1175 MONTAUK HIGHWAY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4939
Mailing Address - Country:US
Mailing Address - Phone:833-666-6066
Mailing Address - Fax:631-337-7698
Practice Address - Street 1:1175 MONTAUK HIGHWAY
Practice Address - Street 2:SUITE 6
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4939
Practice Address - Country:US
Practice Address - Phone:833-666-6066
Practice Address - Fax:631-337-7698
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2023-10-06
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Provider Licenses
StateLicense IDTaxonomies
NY261751207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery