Individual
ANTHONY VASSALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305
(718) 226-9158
(718) 226-6964
Mailing address
1 EDGEWATER ST, 6TH FLOOR, STATEN ISLAND, NY 10305-4900
(718) 226-4324
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
245047
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02892226
—
NY
01
—
P00459973
RR MEDICARE ID
NY
Enumeration date
07/19/2007
Last updated
12/16/2010
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