Basic Information
| Provider Information | |||||||||
| NPI: | 1831179787 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HASSETT | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 11835 RT 9W | ||||||||
| Address2: | |||||||||
| City: | WEST COXSACKIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121923605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187319000 | ||||||||
| FaxNumber: | 5187319119 | ||||||||
| Practice Location | |||||||||
| Address1: | 11835 RT 9W | ||||||||
| Address2: | |||||||||
| City: | WEST COXSACKIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121923605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187319000 | ||||||||
| FaxNumber: | 5187319119 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 01/22/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 2245561 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 290528 | 01 | WELLCARE | OTHER | 857V5 | 01 | BLUE CROSS NON MEDICARE | OTHER | WEL75 | 01 | BLUE CROSS MEDICARE PATIE | OTHER | 000402845002 | 01 | BLUE SHIELD NENY | OTHER | 4937930001 | 01 | NY | MEDICARE DME | OTHER | 040426005959 | 01 | FIDELIS | OTHER | 10062169 | 01 | ODPHP | OTHER |