Healthcare Provider Details

I. General information

NPI: 1821917022
Provider Name (Legal Business Name): ALTRISNYCLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E 69TH ST
NEW YORK NY
10021-5022
US

IV. Provider business mailing address

125 E 69TH ST
NEW YORK NY
10021-5022
US

V. Phone/Fax

Practice location:
  • Phone: 917-633-5750
  • Fax:
Mailing address:
  • Phone: 917-633-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: VISHAL THANIK
Title or Position: FOUNDER
Credential: MD
Phone: 347-237-7715