Provider Demographics
NPI:1245201847
Name:ZILKHA, NAIMA GILA I (MD)
Entity type:Individual
Prefix:
First Name:NAIMA
Middle Name:GILA
Last Name:ZILKHA
Suffix:I
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 1:360 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4403
Mailing Address - Country:US
Mailing Address - Phone:631-422-1110
Mailing Address - Fax:631-422-1916
Practice Address - Street 1:360 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795
Practice Address - Country:US
Practice Address - Phone:631-422-1110
Practice Address - Fax:631-422-1916
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198566-1207W00000X
NY198566207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01857950Medicaid
NYG69568Medicare UPIN
NY95T141Medicare ID - Type Unspecified