Individual
DR. JONATHAN AUSTIN DEASSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICOLLS RD RM 80, STONY BROOK, NY 11794-0001
(631) 444-3880
(631) 444-3919
Mailing address
289 KRAMER AVE, STATEN ISLAND, NY 10309-4275
(347) 907-1776
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
308087
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2018
Last updated
05/20/2021
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