Healthcare Provider Details

I. General information

NPI: 1336200377
Provider Name (Legal Business Name): MICHAEL J. SASSO DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 HURFFVILLE CROSS KEYS ROAD
SEWELL NJ
08080-9202
US

IV. Provider business mailing address

338 HURFFVILLE CROSS KEYS ROAD
SEWELL NJ
08080-9202
US

V. Phone/Fax

Practice location:
  • Phone: 856-589-0600
  • Fax: 856-589-7979
Mailing address:
  • Phone: 856-589-0600
  • Fax: 856-589-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM QUINN
Title or Position: COO
Credential:
Phone: 856-669-6061