Healthcare Provider Details

I. General information

NPI: 1669982849
Provider Name (Legal Business Name): JASMINE SANTI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7300
US

IV. Provider business mailing address

2702 NORTHAMPTON ST
BETHLEHEM PA
18020-5437
US

V. Phone/Fax

Practice location:
  • Phone: 484-884-9677
  • Fax: 484-884-9297
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA14339
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA059301
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMA059301
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: