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NPI Code Detail

MEDICARE: HIDEO TAKAHASHI M.D.

MEDICARE: HIDEO TAKAHASHI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086X0206XSurgical Oncology Physician292639NY
2208600000XSurgery PhysicianMD2026-0493NM

General Provider Information

NPI Number : 1083055958
Entity Type Code : Individual
Provider Name (Legal Business Name) : HIDEO TAKAHASHI M.D.
Provider Business Mailing Address
First Line : 1 S CENTRAL AVE
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-5443
Country : US
Telephone Number : 516-632-3359
Fax Number : 516-632-3355
Provider Business Practice Location Address
First Line : 1 S CENTRAL AVE
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-5443
Country : US
Telephone Number : 516-632-3359
Fax Number : 516-632-3355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 05/29/2026

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