Provider Demographics
NPI:1861656506
Name:DELLI SANTE, ANGELA T (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:T
Last Name:DELLI SANTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 RIVERSIDE DR
Mailing Address - Street 2:#1512
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4143
Mailing Address - Country:US
Mailing Address - Phone:212-864-0379
Mailing Address - Fax:212-864-0379
Practice Address - Street 1:1651 3RD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3679
Practice Address - Country:US
Practice Address - Phone:212-864-0379
Practice Address - Fax:212-864-0379
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011689-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist