Healthcare Provider Details

I. General information

NPI: 1366779068
Provider Name (Legal Business Name): MARIAM RASHEED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2009
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 BLONDELL AVE STE 101
BRONX NY
10461-2601
US

IV. Provider business mailing address

1525 BLONDELL AVE STE 101
BRONX NY
10461-2601
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8530
  • Fax: 718-405-8533
Mailing address:
  • Phone: 718-405-8530
  • Fax: 718-405-8533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number254357
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: