Healthcare Provider Details

I. General information

NPI: 1285693515
Provider Name (Legal Business Name): SUBASINI DASH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 ESSEX STREET SUITE 202
HACKENSACK NJ
07601
US

IV. Provider business mailing address

211 ESSEX STREET SUITE 202
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-1515
  • Fax: 201-488-9471
Mailing address:
  • Phone: 201-488-1515
  • Fax: 201-488-9471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA07576100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number234126
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02620717
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 2
Identifier0112160
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: