MEDICARE: DENNIS FASSMAN DPM

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	213E00000X	Podiatrist	N002845-1	NY

General Provider Information

NPI Number	:	1528000437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS FASSMAN DPM

Provider Business Mailing Address
First Line	:	372 POST AVE
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-2201
Country	:	US
Telephone Number	:	516-333-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	372 POST AVE
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-2201
Country	:	US
Telephone Number	:	516-333-5566
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	02/04/2011

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