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General NPI Number Information
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NPI Number | 1326383910
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Entity Type | Organization
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Legal Business Name | DEEPAK VASISHTHA PHYSICIAN PC
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 209 BEACH 125TH ST
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City | BELLE HARBOR
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State | NY
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Zip | 11694-1703
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Country | US
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Telephone | 718-310-3350
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Fax | 718-228-9317
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Provider Business Mailing Address
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Address Line | 544 PARK AVE 600
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City | BROOKLYN
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State | NY
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Zip | 11205-1600
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Country | US
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Telephone | 718-310-3350
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Fax | 718-228-9317
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DEEPAK VASISHTHA
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Credential | MD
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Telephone | 718-310-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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