Provider Demographics
NPI:1699812412
Name:GATTASSO, SANDRA S (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:S
Last Name:GATTASSO
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7133
Mailing Address - Country:US
Mailing Address - Phone:413-443-5238
Mailing Address - Fax:
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-445-9117
Practice Address - Fax:413-445-9449
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA143887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily