Provider Demographics
NPI:1982919171
Name:HAKIMI, EDMOND (DO)
Entity type:Individual
Prefix:DR
First Name:EDMOND
Middle Name:
Last Name:HAKIMI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 JAN WAY
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-3005
Mailing Address - Country:US
Mailing Address - Phone:631-508-5506
Mailing Address - Fax:631-910-2322
Practice Address - Street 1:525 JAN WAY
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-3005
Practice Address - Country:US
Practice Address - Phone:631-508-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268985207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine