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NPI Code Detail

MEDICARE: DEBORAH DE SANTIS-MONIACI PHD

MEDICARE: DEBORAH DE SANTIS-MONIACI PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent Psychologist015630NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1015630-A15OTHERNYHEALTH FIRST
2P3026682OTHERNYOXFORD HEALTH PLAN
3241556OTHERNYUNITED BEHAVIORAL HEALTH
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
52150034OTHERNYFIRST HEALTH

General Provider Information

NPI Number : 1770578197
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH DE SANTIS-MONIACI PHD
Provider Business Mailing Address
First Line : 977 48TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2919
Country : US
Telephone Number : 718-283-8020
Fax Number : 718-635-7235
Provider Business Practice Location Address
First Line : 948 48TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2918
Country : US
Telephone Number : 718-283-8020
Fax Number : 718-635-7235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 07/08/2007

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