Provider Demographics
NPI:1114002276
Name:SANTY, JOEL T (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:T
Last Name:SANTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 FINNEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1038
Mailing Address - Country:US
Mailing Address - Phone:518-483-2804
Mailing Address - Fax:518-483-2872
Practice Address - Street 1:9 FINNEY BLVD
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1038
Practice Address - Country:US
Practice Address - Phone:518-483-2804
Practice Address - Fax:518-483-2872
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0087171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U67395Medicare UPIN
CC7507Medicare ID - Type Unspecified