Provider Demographics
NPI:1194462903
Name:IDRIS, AHAD MUHAMMAD (DO)
Entity type:Individual
Prefix:DR
First Name:AHAD
Middle Name:MUHAMMAD
Last Name:IDRIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2518
Mailing Address - Country:US
Mailing Address - Phone:631-991-3506
Mailing Address - Fax:631-991-3512
Practice Address - Street 1:291 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2518
Practice Address - Country:US
Practice Address - Phone:631-991-3506
Practice Address - Fax:631-991-3512
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine