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General NPI Number Information
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NPI Number | 1609143932
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Entity Type | Individual
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Provider Name | VIRGINIA ANN DE SANCTIS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 344 E MAIN ST STE 202
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3036
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Country | US
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Telephone | 914-355-8904
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Fax | 914-828-0064
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Provider Business Mailing Address
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Address Line | 311 KENT RD
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City | KENT
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State | CT
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Zip | 06757-1412
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Country | US
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Telephone | 516-633-4812
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 019518
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License Number State | NY
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