Provider Demographics
NPI:1215986708
Name:SASSO, LOUIS AUGUSTUS (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:AUGUSTUS
Last Name:SASSO
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 1:501 SEAVIEW AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-980-5700
Mailing Address - Fax:718-980-5499
Practice Address - Street 1:501 SEAVIEW AVE
Practice Address - Street 2:STE 102
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-980-5700
Practice Address - Fax:718-980-5499
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116353207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
165302OtherELDERPLAN
0431452002OtherCIGNA
OS116OtherOXFORD
2900044OtherGHI
90159OtherAETNA
116353OtherHIP
4C4191OtherTOUCHSTONE
NY00728152Medicaid
116353C11OtherHEALTHFIRST
351291OtherBLUE CROSS
116353OtherHIP
B13615Medicare UPIN