Provider Demographics
NPI:1013608090
Name:DISANTI, DANIELLA
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:
Last Name:DISANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 SARIES CT
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1125
Mailing Address - Country:US
Mailing Address - Phone:516-659-6205
Mailing Address - Fax:
Practice Address - Street 1:3810 SARIES CT
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1125
Practice Address - Country:US
Practice Address - Phone:516-659-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker