Provider Demographics
NPI:1356351050
Name:TASSO, SILVIO R (MD)
Entity type:Individual
Prefix:DR
First Name:SILVIO
Middle Name:R
Last Name:TASSO
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 1:24818 UNION TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426
Mailing Address - Country:US
Mailing Address - Phone:718-347-7621
Mailing Address - Fax:718-347-4564
Practice Address - Street 1:24818 UNION TURNPIKE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:718-347-7621
Practice Address - Fax:718-347-4564
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1768202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01134601Medicaid
E37756Medicare UPIN
NY01673Medicare ID - Type Unspecified