Provider Demographics
NPI:1437306743
Name:SASSON, SASSY (DSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SASSY
Middle Name:
Last Name:SASSON
Suffix:
Gender:M
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6925 MANSE ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5849
Mailing Address - Country:US
Mailing Address - Phone:718-544-0870
Mailing Address - Fax:718-544-0870
Practice Address - Street 1:6925 MANSE ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5849
Practice Address - Country:US
Practice Address - Phone:718-544-0870
Practice Address - Fax:718-544-0870
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03380Medicare PIN