Individual provider · Type 1 NPI
Raphaela Gassanov, PA
Medical Physician Assistant · New York, NY
NPI number
1780388454
Active
Practice location
110 W 14th St
New York, NY 10011-7303
Mailing address
1355 E 18th St Apt 6C
Brooklyn, NY 11230-7567
Other practice locations
- 912 Columbus Ave, New York, NY 10025-4040 · (212) 481-3333
- 332 E 14th St, New York, NY 10003-4243 · (212) 481-3333
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 029741 (NY) |
Medical Physician Assistant: Definition to come...
2 other providers at this address
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About NPI 1780388454
Raphaela Gassanov, PA's National Provider Identifier is 1780388454, issued on Mar 28, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New York, NY. The record was last updated on Mar 28, 2023.