Provider Demographics
NPI:1699893958
Name:RASSOW, BARBARA F (DC CNM)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:F
Last Name:RASSOW
Suffix:
Gender:F
Credentials:DC CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3216
Mailing Address - Country:US
Mailing Address - Phone:203-226-7722
Mailing Address - Fax:
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3216
Practice Address - Country:US
Practice Address - Phone:203-226-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000454111NN1001X
CT000304367A00000X
NYF001279-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001279OtherLICENSE#
CTT22943Medicare UPIN