# 37 MAIN STREET MEDICAL CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MainStreet Med
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366208639
- **Authorized official:** KAMRAN SIDDIQUI (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (516) 600-0676

## Contact information

- **Practice address:** 2094 MERRICK AVE, MERRICK, NY 11566-3147
- **Practice address phone:** (516) 600-0676
- **Practice address fax:** (516) 863-2963
- **Mailing address:** 2094 MERRICK AVE, MERRICK, NY 11566-3147
- **Mailing address phone:** (516) 600-0676
- **Mailing address fax:** (718) 709-4282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/26/2024
- **Last updated:** 09/19/2025