Healthcare Provider Details

I. General information

NPI: 1194585513
Provider Name (Legal Business Name): MERMAID MEDICAL & DIAGNOSTICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 EASTCHESTER RD
BRONX NY
10461-2347
US

IV. Provider business mailing address

81 ROOSEVELT AVE
VALLEY STREAM NY
11581
US

V. Phone/Fax

Practice location:
  • Phone: 929-685-0025
  • Fax:
Mailing address:
  • Phone: 516-962-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RASHED ABEDIN
Title or Position: CEO
Credential: M.D.
Phone: 516-962-9450