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General NPI Number Information
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NPI Number | 1033388731
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Entity Type | Organization
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Legal Business Name | MICHAEL AHDOOT, MD, PC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 4601 QUEENS BLVD
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City | SUNNYSIDE
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State | NY
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Zip | 11104-1711
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Country | US
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Telephone | 718-565-2020
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Fax | 718-565-2052
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Provider Business Mailing Address
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Address Line | PO BOX 231297
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City | GREAT NECK
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State | NY
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Zip | 11023-0297
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Country | US
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Telephone | 516-672-3030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL AHDOOT
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Credential | M.D.
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Telephone | 516-672-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 230961
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License Number State | NY
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