Healthcare Provider Details

I. General information

NPI: 1831884956
Provider Name (Legal Business Name): ASHRAF KHAFAGA MD, DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27005 76TH AVE
NEW HYDE PARK NY
11040-1402
US

IV. Provider business mailing address

1300 N FRESNO ST
FRESNO CA
93703-3845
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-4557
  • Fax:
Mailing address:
  • Phone: 917-250-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number6255
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: