Healthcare Provider Details

I. General information

NPI: 1114822186
Provider Name (Legal Business Name): NB DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 BRANT AVE
CLARK NJ
07066-1513
US

IV. Provider business mailing address

1344 DANCHETZ CT
RAHWAY NJ
07065-5089
US

V. Phone/Fax

Practice location:
  • Phone: 732-443-3375
  • Fax: 732-443-3329
Mailing address:
  • Phone: 732-443-3375
  • Fax: 732-443-3329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL

VIII. Authorized Official

Name: NIKETABEN VASANI
Title or Position: OWNER
Credential:
Phone: 908-414-0933