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General NPI Number Information
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NPI Number | 1881638740
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Entity Type | Individual
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Provider Name | EDWARD A SASSAMAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 1850 BRIGHTON HENRIETTA TOWN LINE ROAD
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City | ROCHESTER
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State | NY
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Zip | 14623
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Country | US
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Telephone | 585-424-6210
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Fax | 585-424-1202
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Provider Business Mailing Address
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Address Line | 800 CARTER STREET
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City | ROCHESTER
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State | NY
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Zip | 14621
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Country | US
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Telephone | 585-339-4793
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Fax | 585-336-4845
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 197323
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 197323
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License Number State | NY
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