Individual
KHADIGA AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
640 HAWKINS AVE, LAKE RONKONKOMA, NY 11779-2324
(631) 471-0100
(631) 471-1000
Mailing address
55 WATER ST FL 2, NEW YORK, NY 10041-0010
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
288031
MA
207Q00000X
Family Medicine Physician
Primary
329788
NY
Other
Enumeration date
04/05/2018
Last updated
09/12/2025
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