Provider Demographics
NPI:1164950622
Name:SASSANI, EMILEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:
Last Name:SASSANI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:
Other - Last Name:MALLAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:3100 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-3548
Practice Address - Country:US
Practice Address - Phone:717-948-5180
Practice Address - Fax:717-948-0488
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004148363A00000X
363AM0700X
PAMA059032363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical