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General NPI Number Information
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NPI Number | 1598355455
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Entity Type | Individual
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Provider Name | CHRISTINA MONIQUE DESANTO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2021
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 1251 E MAIN ST
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City | ANNVILLE
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State | PA
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Zip | 17003-1643
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Country | US
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Telephone | 717-867-4671
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Fax | 717-867-4981
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Provider Business Mailing Address
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Address Line | 1251 E MAIN ST
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City | ANNVILLE
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State | PA
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Zip | 17003-1643
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Country | US
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Telephone | 717-867-4671
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Fax | 717-867-4981
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00602000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA061955
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License Number State | PA
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