Healthcare Provider Details

I. General information

NPI: 1275868010
Provider Name (Legal Business Name): NASSER KHAN GHASSEMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 E 51ST ST APT 1
NEW YORK NY
10022-6753
US

IV. Provider business mailing address

323 E 51ST ST APT 1
NEW YORK NY
10022-6753
US

V. Phone/Fax

Practice location:
  • Phone: 212-751-2429
  • Fax: 646-201-4160
Mailing address:
  • Phone: 212-751-2429
  • Fax: 646-201-4160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License Number100899
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: