| Sasha D Fassett Licensed Clinical Social Worker Pc | |
|
217 Jefferson Ave Endicott NY 13760-5244 | |
| (607) 237-5411 | |
| Not Available |
| Full Name | Sasha D Fassett Licensed Clinical Social Worker Pc |
|---|---|
| Speciality | Social Worker |
| Location | 217 Jefferson Ave, Endicott, New York |
| Authorized Official Name and Position | Sasha D Fassett (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6072375411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sasha D Fassett Licensed Clinical Social Worker Pc 217 Jefferson Ave Endicott NY 13760-5244 Ph: (607) 237-5411 | Sasha D Fassett Licensed Clinical Social Worker Pc 217 Jefferson Ave Endicott NY 13760-5244 Ph: (607) 237-5411 |
| NPI Number | 1033457163 |
|---|---|
| Provider Enumeration Date | 01/24/2013 |
| Last Update Date | 01/24/2013 |
| Medicare PECOS PAC ID | 4789942632 |
|---|---|
| Medicare Enrollment ID | O20171222000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033457163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R069367-1 (New York) | Primary |
| Provider Name | Sasha D Fassett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114949062 PECOS PAC ID: 3173622677 Enrollment ID: I20070625000442 |
| Provider Name | Kathleen M Loftus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346473790 PECOS PAC ID: 1951438365 Enrollment ID: I20100416000016 |
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