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General NPI Number Information
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NPI Number | 1558249938
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Entity Type | Organization
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Legal Business Name | MR TRICOUNTY MEDICAL PC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1787 MIDDLE COUNTRY RD
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City | CENTEREACH
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State | NY
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Zip | 11720-3507
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Country | US
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Telephone | 631-320-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 48 PARK DR E
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City | SYOSSET
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State | NY
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Zip | 11791-5214
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Country | US
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Telephone | 917-846-3079
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAYADHA RASHEED
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Credential | DO
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Telephone | 631-320-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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