Individual provider Active NPI

Zahidur R Abedin, PHD

  • Clinical Laboratory Director (Non-physician)
  • Garnet Valley, PA
National Provider Identifier
1174239669
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
CQP153590 Issued in NY
Practice address
3070 McCann Farm Dr Ste 112
Garnet Valley, PA 19060-2131
Phone
(610) 458-1112
NPI assigned
Jan 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X CQP153590 NY Primary

Addresses

Primary practice location

3070 McCann Farm Dr Ste 112
Garnet Valley, PA 19060-2131

Mailing address

3070 McCann Farm Dr Ste 112
Garnet Valley, PA 19060-2131
Phone (610) 458-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CQP153590NYMDClinical Laboratory Director (Non-physician)

Practice roles

OrganizationSpecialtyStatusNew patients
Primbio Research Institute LLC CurrentSince Jan 29, 2023 Accepting new patients

Locations

3070 McCann Farm Dr
Ste 112
Garnet Valley, PA 19060
Phone (610) 458-1112

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1174239669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MCCANN FARM DR STE 112",
            "city": "GARNET VALLEY",
            "state": "PA",
            "postal_code": "190602131",
            "telephone_number": "610-458-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 MCCANN FARM DR STE 112",
            "city": "GARNET VALLEY",
            "state": "PA",
            "postal_code": "190602131",
            "telephone_number": "610-458-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEDIN",
        "first_name": "ZAHIDUR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "NY",
            "license": "CQP153590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garnet Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.