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General NPI Number Information
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NPI Number | 1619973674
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Entity Type | Individual
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Provider Name | LUIGI DE SANTIS MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 50 SERPENTINE LN
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City | LEVITTOWN
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State | PA
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Zip | 19055-2213
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Country | US
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Telephone | 215-946-4410
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Fax | 215-946-5846
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Provider Business Mailing Address
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Address Line | PO BOX 8500-6335
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City | PHILADELPHIA
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State | PA
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Zip | 19178-6335
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Country | US
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Telephone | 215-946-4410
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Fax | 215-946-5846
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD034446E
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License Number State | PA
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