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General NPI Number Information
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NPI Number | 1629064423
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Entity Type | Individual
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Provider Name | JOSEPH VINCENT DE SANTI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 361 BOILER HOUSE RD BLDG 361
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City | PERRY POINT
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State | MD
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Zip | 21902-1103
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Country | US
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Telephone | 410-642-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 2718 WOODSPRING DR
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City | YORK
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State | PA
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Zip | 17402-8521
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Country | US
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Telephone | 717-718-5465
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD423667
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD423667
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License Number State | PA
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