Desantis, Maryanne

Desantis, Maryanne is an individual health care provider with primary practice located at 375 Seguine Ave , Staten Island NY 10309-3932. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Desantis, Maryanne can be contacted via phone (718) 226-2440.

Contact Information

Primary practice address
375 Seguine Ave Staten Island NY 10309-3932
Phone: (718) 226-2440
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 190585 New York
Allopathic & Osteopathic Physicians / Forensic Psychiatry 2084F0202X 190585 New York
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 190585 New York

Profile Details

NPI number 1174507594
LBN Legal business name Desantis, Maryanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Aug 1st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174507594 NPPES
New York Other P00602172 RAILROAD MEDICARE
New York Other DN0541 RAILROAD MEDICARE
New York Other 260049316 RAILROAD MEDICARE
New York MEDICAID 02106196 RAILROAD MEDICARE

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