Healthcare Provider Details

I. General information

NPI: 1679213185
Provider Name (Legal Business Name): NAIM FOUAD MEKDESSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 BELMONT ST
BROCKTON MA
02301-5596
US

IV. Provider business mailing address

3 COUNTRY CT
HOUSTON TX
77024-7434
US

V. Phone/Fax

Practice location:
  • Phone: 774-826-2458
  • Fax: 774-826-1859
Mailing address:
  • Phone: 832-659-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number345798
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: