Provider Demographics
NPI:1356490601
Name:DELLI SANTI, PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:DELLI SANTI
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 1:41 WILSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-344-4848
Mailing Address - Fax:973-344-1886
Practice Address - Street 1:41 WILSON AVENUE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-344-4848
Practice Address - Fax:973-344-1886
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00193900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45505Medicare UPIN
NJ456102TZWMedicare PIN