Provider Demographics
NPI:1396985362
Name:SANTELLI, JEANINE TERESA (PHD, ANP-BC/GNP-BC)
Entity type:Individual
Prefix:DR
First Name:JEANINE
Middle Name:TERESA
Last Name:SANTELLI
Suffix:
Gender:F
Credentials:PHD, ANP-BC/GNP-BC
Other - Prefix:
Other - First Name:JEANINE
Other - Middle Name:TERESA
Other - Last Name:SEGUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1731
Mailing Address - Country:US
Mailing Address - Phone:585-396-6000
Mailing Address - Fax:
Practice Address - Street 1:350 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1731
Practice Address - Country:US
Practice Address - Phone:585-396-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301108363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health