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General NPI Number Information
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NPI Number | 1255775227
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Entity Type | Organization
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Legal Business Name | MERRIDERM DERMATOLOGY PLLC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3644 MAIN ST # 2NDFL
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City | FLUSHING
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State | NY
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Zip | 11354-4143
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Country | US
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Telephone | 347-732-0690
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Fax | 347-732-0691
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Provider Business Mailing Address
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Address Line | 3644 MAIN ST # 2NDFL
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City | FLUSHING
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State | NY
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Zip | 11354-4143
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Country | US
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Telephone | 347-732-0690
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Fax | 347-732-0691
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | WENHONG ZHOU
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Credential |
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Telephone | 917-770-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 266027
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License Number State | NY
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