Edmond Hakimi, D.O
Individual provider Active NPI Addiction Medicine (Internal Medicine) Physician · Calverton, NY
NPI 1982919171 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1982919171
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Internal Medicine) Physician 207RA0401X
- License
- 268985 (NY)
- Practice address
- 525 Jan Way
Calverton, NY 11933-3005 - Phone
- (631) 508-5400
- NPI assigned
- Aug 11, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 268985 | NY | MD | Addiction Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ebdk at Calverton | Current |
Accepting new patients |
Locations
525 Jan Way
Calverton, NY 11933
Phone (631) 508-5400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 268985 | NY | Yes |
Addresses
Primary practice location
525 Jan Way
Calverton, NY 11933-3005
Mailing address
525 Jan Way
Calverton, NY 11933-3005
Phone (631) 508-5506
Other providers in Calverton, NY
- Ebdk at Calverton
- Ashleigh Kristin Gardner
- Shana Marie Glynn
- Alison Ann Gomez
- Jette Grefe
- Healthcare Support Systems, Inc.
- Jennifer S James
- Georgina Kathryn Kamide
- Janet Lynn Kantor
- Patricia Marie Kelly
All providers in Calverton, NY · Addiction Medicine (Internal Medicine) Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.