Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P94790 | MD |
Y | 222Z00000X | Podiatrist | P94790 | MD |
NPI | 1053852822 |
---|---|
Provider Name | Dr. Lion Sassoon |
First Address | Silver Spring, MD 20902-3324 |
Second Address | Greenbelt, MD 20770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2017 |
Last Update Date | 04/07/2018 |