Provider Demographics
NPI:1073563953
Name:SASSON, AARON R (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:R
Last Name:SASSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-2034
Mailing Address - Fax:
Practice Address - Street 1:HST LEVEL 18 RM 065
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8191
Practice Address - Country:US
Practice Address - Phone:631-444-8086
Practice Address - Fax:631-444-7871
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21829208600000X, 2086X0206X
NY2817082086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557580Medicaid
NE47078557580Medicaid
NEG94201Medicare UPIN