Healthcare Provider Details

I. General information

NPI: 1497490189
Provider Name (Legal Business Name): ABBEY JEANNE SANTANELLO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NYU LANGONE HOSPITAL 550 FIRST AVE.
NEW YORK NY
10016
US

IV. Provider business mailing address

4664 HAYDEN RUN RD
COLUMBUS OH
43221-5937
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5506
  • Fax:
Mailing address:
  • Phone: 614-551-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number1497490189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: