Healthcare Provider Details

I. General information

NPI: 1215873864
Provider Name (Legal Business Name): ANASTASIIA VASILEVA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 QUARRY RD, BRONX MEDICAL EDUCATION MILLS BUILDING, 3RD FLOOR
NEW YORK NY
10457
US

IV. Provider business mailing address

2101 QUARRY RD, BRONX MEDICAL EDUCATION MILLS BUILDING, 3RD FLOOR
NEW YORK NY
10457
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-6202
  • Fax: 718-960-3218
Mailing address:
  • Phone: 718-960-6202
  • Fax: 718-960-3218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: