Individual
DR. KENNETH CLAYTON SASSOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 PARKMAN ST, WAC 835, BOSTON, MA 02114-3117
(617) 724-7426
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-7426
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
152034
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3164195
—
MA
01
—
758591
TUFTS HEALTH PLAN
MA
01
—
J17462
BCBS MA
MA
Enumeration date
11/03/2005
Last updated
11/05/2012
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