Organization
37 MAIN STREET MEDICAL CARE PC
Active
Other names
MainStreet Med
Organization subpart
No
Provider details
NPI number
Authorized official
KAMRAN SIDDIQUI (CHIEF EXECUTIVE OFFICER)
(516) 600-0676
Entity
Organization
Contact information
Practice address
2094 MERRICK AVE, MERRICK, NY 11566-3147
(516) 600-0676
(516) 863-2963
Mailing address
2094 MERRICK AVE, MERRICK, NY 11566-3147
(516) 600-0676
(718) 709-4282
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02473412
—
NY
Enumeration date
02/26/2024
Last updated
09/19/2025
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