Healthcare Provider Details

I. General information

NPI: 1407098098
Provider Name (Legal Business Name): JUSTIN HAKIMIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DR
MANHASSET NY
11030-3816
US

IV. Provider business mailing address

1 DAKOTA DR SUITE 310
NEW HYDE PARK NY
11042-1119
US

V. Phone/Fax

Practice location:
  • Phone: 516-465-2587
  • Fax:
Mailing address:
  • Phone: 516-390-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number259919
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number259919
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: