Provider Demographics
NPI:1417946781
Name:ADHIKARI, DEBASIS (MD)
Entity Type:Individual
Prefix:
First Name:DEBASIS
Middle Name:
Last Name:ADHIKARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 55TH ST
Mailing Address - Street 2:ATTN: PHYSICIAN BILLING DEPT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2559
Mailing Address - Country:US
Mailing Address - Phone:718-630-7379
Mailing Address - Fax:718-630-4672
Practice Address - Street 1:3269 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1300
Practice Address - Country:US
Practice Address - Phone:516-270-7675
Practice Address - Fax:718-630-4672
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235564207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY57R861Medicare ID - Type Unspecified
NYI32496Medicare UPIN