Provider Demographics
NPI:1902674021
Name:STEPHEN H FASSMAN DMDPC
Entity Type:Organization
Organization Name:STEPHEN H FASSMAN DMDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/SEC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:FASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:STEPHEN FASSMAN DDS
Authorized Official - Phone:212-689-2000
Mailing Address - Street 1:630 5TH AVE STE 1818
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10111-1873
Mailing Address - Country:US
Mailing Address - Phone:212-689-2000
Mailing Address - Fax:845-544-2754
Practice Address - Street 1:630 5TH AVE STE 1818
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10111-1873
Practice Address - Country:US
Practice Address - Phone:212-689-2000
Practice Address - Fax:845-544-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental