Provider Demographics
NPI:1982689048
Name:VASISHTHA, NEERAJ (MD)
Entity Type:Individual
Prefix:
First Name:NEERAJ
Middle Name:
Last Name:VASISHTHA
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 1:44 BIRCH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2752
Mailing Address - Country:US
Mailing Address - Phone:603-421-2380
Mailing Address - Fax:603-421-2386
Practice Address - Street 1:44 BIRCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2752
Practice Address - Country:US
Practice Address - Phone:603-421-2380
Practice Address - Fax:603-421-2386
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13568207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3081961Medicaid
NHP00988968Medicare PIN
H72294Medicare UPIN
NH000228307Medicare PIN
NH000228307Medicare PIN
KS100398540AMedicaid
NH000228307Medicare PIN