Individual
AHMED IMTIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(631) 654-7100
Mailing address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(631) 654-7100
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101276545
VA
2084P0800X
Psychiatry Physician
Primary
341070
NY
Other
Enumeration date
03/31/2020
Last updated
02/14/2026
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