Doctor Name: | CHRISTINE B DESANTIS |
NPI Number: | 1558481044 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 26NJ00061400 |
Business Practice Address: | 1427 Wyckoff Rd Horizon Bcbs-healthcenter Wall Township, NJ - 077273918 |
Business Phone Number: | 7322565044 |
Business Fax Number: | 7322565045 |
Mailing Address: | 88 Hannah Pl, BAYVILLE |
State: | NJ |
Postal Code: | 087212065 |
Phone Number: | 7326060031 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00061400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |