Healthcare Provider Details

I. General information

NPI: 1225665532
Provider Name (Legal Business Name): AMIRA BEKHIT DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 JERICHO TPKE STE 300
SYOSSET NY
11791-4538
US

IV. Provider business mailing address

11 ELMWOOD LN
SYOSSET NY
11791-6123
US

V. Phone/Fax

Practice location:
  • Phone: 516-259-0469
  • Fax:
Mailing address:
  • Phone: 267-642-4467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN007317
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: