Donald Sassman, RPH

Individual provider Active NPI Pharmacist · Waverly, NY

NPI 1346457249 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1346457249
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
040123 (NY)
Practice address
316 Broad St
Waverly, NY 14892-1326
Phone
(607) 936-2178
Fax
(607) 565-2393
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
040123NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal City Apothecary LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040123 NY Yes

Addresses

Primary practice location

316 Broad St
Waverly, NY 14892-1326

Mailing address

316 Broad St
Waverly, NY 14892-1326
Phone (607) 936-2178

Other providers in Waverly, NY

All providers in Waverly, NY · Pharmacist in New York

Sources for this page

Verify at the official NPI Registry.