Provider Demographics
NPI:1508862913
Name:DESANGES, JANEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:DESANGES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 ANDERSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-1402
Mailing Address - Country:US
Mailing Address - Phone:914-251-6380
Mailing Address - Fax:
Practice Address - Street 1:735 ANDERSON HILL RD
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-1402
Practice Address - Country:US
Practice Address - Phone:914-251-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0048881363A00000X
FLPA9104548363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant