Provider Demographics
NPI:1366470049
Name:SASSON, AARON DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:DANIEL
Last Name:SASSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:A. DANIEL
Other - Middle Name:
Other - Last Name:SASSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:101 DATES DR
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1342
Mailing Address - Country:US
Mailing Address - Phone:607-274-4134
Mailing Address - Fax:607-277-3849
Practice Address - Street 1:101 DATES DR
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1342
Practice Address - Country:US
Practice Address - Phone:607-274-4134
Practice Address - Fax:607-277-3849
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2414292085R0202X, 2085R0204X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02923802Medicaid
NY02923802Medicaid