Provider Demographics
NPI:1902628035
Name:RASSOULI, SEYED ALIPASHA (MD, FRCSC, FACS)
Entity type:Individual
Prefix:DR
First Name:SEYED
Middle Name:ALIPASHA
Last Name:RASSOULI
Suffix:
Gender:M
Credentials:MD, FRCSC, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH YORK
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N4K 6L5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1979 16TH STREET EAST
Practice Address - Street 2:UNIT #E3
Practice Address - City:OWEN SOUND
Practice Address - State:ONTARIO
Practice Address - Zip Code:N4K 5N3
Practice Address - Country:CA
Practice Address - Phone:226-909-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278965207YS0123X
FLME171032207YS0123X
PAMD445873207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology