Provider Demographics
NPI:1942364583
Name:SASSOON, ROBERT I
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:I
Last Name:SASSOON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 E 68TH ST
Mailing Address - Street 2:2ND FLOOR, SUITE 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6310
Mailing Address - Country:US
Mailing Address - Phone:212-628-1500
Mailing Address - Fax:212-327-1311
Practice Address - Street 1:449 E 68TH ST
Practice Address - Street 2:2ND FLOOR, SUITE 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6310
Practice Address - Country:US
Practice Address - Phone:212-628-1500
Practice Address - Fax:212-327-1311
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152571-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14705Medicare UPIN