Provider Demographics
NPI:1679741268
Name:SASSON, ISAAC E (MD PHD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:E
Last Name:SASSON
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BANGOR RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2803
Mailing Address - Country:US
Mailing Address - Phone:203-887-7828
Mailing Address - Fax:
Practice Address - Street 1:15001 SHADY GROVE RD STE 340
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6357
Practice Address - Country:US
Practice Address - Phone:301-340-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436246207VE0102X
MDD74003207VE0102X
NJ25MA08682200207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology