Provider Demographics
NPI:1083733281
Name:SANTORO, JOSEPH M (PA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:SANTORO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 ORMOND AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-2622
Mailing Address - Country:US
Mailing Address - Phone:610-446-1950
Mailing Address - Fax:
Practice Address - Street 1:ST FRANCIS HOSPITAL
Practice Address - Street 2:7TH AND CLAYTON STREET
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-421-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000518363AS0400X
PAMA002905L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical