Provider Demographics
NPI:1689971434
Name:DASSA ORTHOPEDIC MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:DASSA ORTHOPEDIC MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:DASSA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-956-1313
Mailing Address - Street 1:7 CARLTON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-4755
Mailing Address - Country:US
Mailing Address - Phone:845-956-1313
Mailing Address - Fax:
Practice Address - Street 1:453 STATE ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-956-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190113207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty