Provider Demographics
NPI:1336200377
Name:MICHAEL J. SASSO DO PC
Entity Type:Organization
Organization Name:MICHAEL J. SASSO DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-669-6061
Mailing Address - Street 1:338 HURFFVILLE CROSS KEYS ROAD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9202
Mailing Address - Country:US
Mailing Address - Phone:856-589-0600
Mailing Address - Fax:856-589-7979
Practice Address - Street 1:338 HURFFVILLE CROSS KEYS ROAD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9202
Practice Address - Country:US
Practice Address - Phone:856-589-0600
Practice Address - Fax:856-589-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty