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General NPI Number Information
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NPI Number | 1043549801
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Entity Type | Individual
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Provider Name | ELLEN MARIE MCCARTY-SANTORO N.P.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 496 SMITHTOWN BYP
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City | SMITHTOWN
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State | NY
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Zip | 11787-5005
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Country | US
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Telephone | 631-979-8880
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Fax | 631-979-8091
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Provider Business Mailing Address
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Address Line | 496 SMITHTOWN BYPASS
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City | SMITHTOWN
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State | NY
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Zip | 11787
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Country | US
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Telephone | 631-979-8880
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Fax | 631-979-8091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 302438
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License Number State | NY
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