Provider Demographics
NPI:1205936168
Name:TASSY, PHILIPPE (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIPPE
Middle Name:
Last Name:TASSY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4445
Mailing Address - Country:US
Mailing Address - Phone:516-489-1284
Mailing Address - Fax:516-489-7045
Practice Address - Street 1:518 FRONT ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4445
Practice Address - Country:US
Practice Address - Phone:516-489-1284
Practice Address - Fax:516-489-7045
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01071907Medicaid
NY01071907Medicaid
NY19E041Medicare ID - Type Unspecified