Provider Demographics
NPI:1659616340
Name:NEXT LEVEL DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:NEXT LEVEL DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:VASISHTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-968-0730
Mailing Address - Street 1:358 5TH AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2209
Mailing Address - Country:US
Mailing Address - Phone:212-730-8172
Mailing Address - Fax:212-730-8173
Practice Address - Street 1:257 S MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3360
Practice Address - Country:US
Practice Address - Phone:845-623-8000
Practice Address - Fax:845-623-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23122322081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty