Healthcare Provider Details
I. General information
NPI: 1669635140
Provider Name (Legal Business Name): UMA B. SASSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/06/2008
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
410 W 10TH AVE
COLUMBUS OH
43210-1240
US
IV. Provider business mailing address
700 ACKERMAN RD STE 570
COLUMBUS OH
43202-1579
US
V. Phone/Fax
- Phone: 614-293-8487
- Fax: 614-293-8153
- Phone: 614-293-8487
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 125054247 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 35.099658 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: