MEDICARE: EILEEN RASSI MD

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	207R00000X	Internal Medicine Physician	203629	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366403180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN RASSI MD

Provider Business Mailing Address
First Line	:	186 JORALEMON ST
Second Line	:	11 FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4356
Country	:	US
Telephone Number	:	646-962-4600
Fax Number	:	718-852-7007

Provider Business Practice Location Address
First Line	:	186 JORALEMON ST
Second Line	:	11 FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4356
Country	:	US
Telephone Number	:	646-962-4600
Fax Number	:	718-852-7007

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	04/01/2021

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