Provider Demographics
NPI:1093719536
Name:HASSASSIAN, SASSAN (MD)
Entity Type:Individual
Prefix:
First Name:SASSAN
Middle Name:
Last Name:HASSASSIAN
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 1:11350 MCCORMICK RD EXECUTIVE PLAZA 1
Mailing Address - Street 2:STE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:703-914-8000
Mailing Address - Fax:703-642-1876
Practice Address - Street 1:8644 SUDLEY RD
Practice Address - Street 2:STE 117
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4417
Practice Address - Country:US
Practice Address - Phone:703-738-4375
Practice Address - Fax:703-642-1876
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230362207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG47181Medicare UPIN
VA720000006Medicare ID - Type Unspecified