Provider Demographics
NPI:1215220405
Name:LATEFI, AHMAD (DO)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:LATEFI
Suffix:
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 1:2200 NORTHERN BLVD STE 230
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1227
Practice Address - Country:US
Practice Address - Phone:516-224-6150
Practice Address - Fax:631-337-7698
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2025-05-21
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Provider Licenses
StateLicense IDTaxonomies
NY261751207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery