Provider Demographics
NPI:1316007784
Name:KASSAN, LEE D (MA)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:D
Last Name:KASSAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W 95TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6644
Mailing Address - Country:US
Mailing Address - Phone:212-932-9070
Mailing Address - Fax:
Practice Address - Street 1:141 W 95TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6644
Practice Address - Country:US
Practice Address - Phone:212-932-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2631101YM0800X
NY565103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis