Provider Demographics
NPI:1518317296
Name:SASSANI, ALEX PATRICK (PA-C)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:PATRICK
Last Name:SASSANI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1017
Mailing Address - Country:US
Mailing Address - Phone:717-231-8869
Mailing Address - Fax:
Practice Address - Street 1:4000 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1017
Practice Address - Country:US
Practice Address - Phone:717-231-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003802363AM0700X
PAMA058227363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical