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General NPI Number Information
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NPI Number | 1194585513
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Entity Type | Organization
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Legal Business Name | MERMAID MEDICAL & DIAGNOSTICS, P.C.
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 81 ROOSEVELT AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11581
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Country | US
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Telephone | 516-962-9450
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Fax |
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Provider Business Mailing Address
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Address Line | 81 ROOSEVELT AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11581
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Country | US
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Telephone | 516-962-9450
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RASHED ABEDIN
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Credential | M.D.
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Telephone | 516-962-9450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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