MEDICARE: ANASTASIYA SASLOFF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	014666-1	NY

General Provider Information

NPI Number	:	1447558580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIYA SASLOFF

Provider Business Mailing Address
First Line	:	856 E 15TH ST APT 3C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1592 E 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7106
Country	:	US
Telephone Number	:	718-627-3992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2011
Last Update Date	:	03/13/2011

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