Provider Demographics
NPI:1609015502
Name:KASSIS, CHRISTELLE E (MD)
Entity type:Individual
Prefix:
First Name:CHRISTELLE
Middle Name:E
Last Name:KASSIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2368
Mailing Address - Country:US
Mailing Address - Phone:602-261-7830
Mailing Address - Fax:602-261-7835
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2368
Practice Address - Country:US
Practice Address - Phone:602-274-7195
Practice Address - Fax:602-274-7097
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01066080A207R00000X
AZ47018207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine