MEDICARE: LUIGI DE SANTIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD034446E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00851209	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45642MD034446E	OTHER	PA	HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	30072737	OTHER	PA	KEYSTONE MERCY
5	0022024000	OTHER	PA	KEYSTONE IBC
6	464063	OTHER	PA	AETNA HMO
7	056410	OTHER	PA	HIGHMARK BLUE SHIELD

General Provider Information

NPI Number	:	1619973674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIGI DE SANTIS MD

Provider Business Mailing Address
First Line	:	PO BOX 8500-6335
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-6335
Country	:	US
Telephone Number	:	215-946-4410
Fax Number	:	215-946-5846

Provider Business Practice Location Address
First Line	:	50 SERPENTINE LN
Second Line	:
City	:	LEVITTOWN
State	:	PA
Zip	:	19055-2213
Country	:	US
Telephone Number	:	215-946-4410
Fax Number	:	215-946-5846

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/06/2011

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Directions to “ LUIGI DE SANTIS MD” Practice Location

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