Provider Demographics
NPI:1962793273
Name:MERMAID MANAGEMENT INC
Entity type:Organization
Organization Name:MERMAID MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-265-0900
Mailing Address - Street 1:170406 MERMAID AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2622
Mailing Address - Country:US
Mailing Address - Phone:718-265-0900
Mailing Address - Fax:718-265-6319
Practice Address - Street 1:1704 06 MERMAID AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2622
Practice Address - Country:US
Practice Address - Phone:718-265-0900
Practice Address - Fax:718-265-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty