Provider Demographics
NPI:1376603159
Name:GASSON, CHRISTIAN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:ANTHONY
Last Name:GASSON
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 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:518-649-4094
Practice Address - Street 1:317 S MANNING BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1738
Practice Address - Country:US
Practice Address - Phone:518-525-1404
Practice Address - Fax:518-525-1517
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2409522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02849892Medicaid
NY02849892Medicaid