Provider Demographics
NPI:1881750552
Name:JASSER, SAMAR AISHA (MD)
Entity type:Individual
Prefix:
First Name:SAMAR
Middle Name:AISHA
Last Name:JASSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11680 E SAHUARO DR UNIT 1033
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4170
Mailing Address - Country:US
Mailing Address - Phone:215-359-5628
Mailing Address - Fax:800-782-8176
Practice Address - Street 1:70 N MCCLINTOCK DR STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3711
Practice Address - Country:US
Practice Address - Phone:480-464-4431
Practice Address - Fax:480-464-2338
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3016442084P0800X
PAMD4324372084P0800X
AZ439192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102341816Medicaid
PA102341816Medicaid