Individual
EVELYN R WASSERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
255 LAFAYETTE ST, SUFFERN, NY 10901
(845) 368-5199
Mailing address
PO BOX 797, 16 KENDALL DRIVE, NEW CITY, NY 10956
(845) 557-0300
(845) 557-0300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
144227
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01348172
—
NY
01
—
611BD1
EMPIRE BLUE CROSS AND BLU
—
Enumeration date
12/26/2006
Last updated
03/19/2008
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