Healthcare Provider Details

I. General information

NPI: 1407922297
Provider Name (Legal Business Name): ELLEN IDA KAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E SHORE RD
GREAT NECK NY
11023-2433
US

IV. Provider business mailing address

9 SHEEP PASTURE LN
HUNTINGTON NY
11743-5135
US

V. Phone/Fax

Practice location:
  • Phone: 516-487-2444
  • Fax:
Mailing address:
  • Phone: 631-692-8548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number128596
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: