Basic Information
| Provider Information | |||||||||
| NPI: | 1154809762 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SASSY MEDICAL SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 321 MAIN ST STE 3D | ||||||||
| Address2: | |||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159011632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145357576 | ||||||||
| FaxNumber: | 8145361369 | ||||||||
| Practice Location | |||||||||
| Address1: | 1599 SOMERSET AVE | ||||||||
| Address2: | |||||||||
| City: | WINDBER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159631745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145357576 | ||||||||
| FaxNumber: | 8145361369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2018 | ||||||||
| LastUpdateDate: | 10/29/2018 | ||||||||
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| AuthorizedOfficialLastName: | HOFFMAN | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8145357576 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.