- Practice location
- 820 2ND Ave Rm 3A, New York, NY 10017-4534
- Phone
- 212-661-3376
- Fax
- 212-661-3366
- Last updated
- September 28, 2023
Michael Tassavor is a Dermatology, MOHS-Micrographic Surgery based in New York, NY. Michael Tassavor practices in New York, NY and has the professional credentials of MD. The NPI Number for Michael Tassavor is 1043707003 and holds a License No. 25MA11789400 (NJ). The current practice location address for Michael Tassavor is 820 2ND Ave Rm 3A, New York, NY 10017-4534 and can be reached out via phone at 212-661-3376 and via fax at 212-661-3366.
Provider Profile Details
- NPI Number
- 1043707003
- Provider Name
- Michael Tassavor
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 820 2ND Ave Rm 3A, New York, NY 10017-4534
- Phone Number
- 212-661-3376
- Fax Number
- 212-661-3366
- Primary Taxonomy
- Dermatology, MOHS-Micrographic Surgery · 207ND0101X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 16, 2018
- Last Update Date
- September 28, 2023
- Certification Date
- September 28, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 820 2ND Ave Rm 3A
New York, NY 10017-4534 - City
- New York
- State
- New York
- Zip
- 10017-4534
- Phone Number
- 212-661-3376
- Fax Number
- 212-661-3366
Provider Business Mailing Address Details
- Address
- 140 Ten Rod Hwy
Rocky Hill, CT 06067-2849 - City
- Rocky Hill
- State
- CT
- Zip
- 06067-2849
- Phone Number
- 212-659-9530
License Information
- License Number (1)
- 25MA11789400
- License State (1)
- NJ
- Taxonomy (1)
- Dermatology, MOHS-Micrographic Surgery · 207ND0101X · Primary
- License Number (2)
- 323010-01
- License State (2)
- NY
- Taxonomy (2)
- Dermatology, MOHS-Micrographic Surgery · 207ND0101X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Michael Tassavor, MD?
The NPI number of Michael Tassavor, MD is 1043707003. It was assigned on April 16, 2018 and is currently active in the NPPES registry.
What is the specialty of Michael Tassavor, MD?
Michael Tassavor, MD is registered under the primary taxonomy Dermatology, MOHS-Micrographic Surgery (code 207ND0101X), licensed in NJ under license number 25MA11789400.
Where does Michael Tassavor, MD practice?
The practice location is 820 2ND Ave Rm 3A, New York, NY 10017-4534. The office can be reached at 212-661-3376 (phone) or 212-661-3366 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1043707003 directly on the NPPES registry website.