Mermaid Medical Wellness.PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

157270 Issued in NY

Legal business name

MERMAID MEDICAL WELLNESS.PC

Practice address

2885 West 15TH Street
Brooklyn, NY 11224

Phone

(917) 916-2371

NPI assigned

Apr 27, 2009

Last updated

Apr 27, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edovard J Hazel, MD

Title

Owner

Phone

(917) 916-2371

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1952545634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 WEST 15TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11224",
            "telephone_number": "917-916-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 WEST 15TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11224",
            "telephone_number": "917-916-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERMAID MEDICAL WELLNESS.PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "HAZEL",
        "authorized_official_first_name": "EDOVARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-916-2371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "157270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mermaid Manor Hfa
• Mermaid Medical Art's PC
• Mermaid Medical PC
• Mermaid Medical Supply Inc
• Mermaid Medical Supply Inc
• Mermaid Operating Co, LLC (Mermaid Health Center)
• Mermaid Optical
• Mermaid Pharmacy Inc
• Mermaid RX Inc
• Hillary Merman, LCSW

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.