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Individual

DR. MARK DESANTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
OS10292
FL
2085B0100X
Body Imaging Physician
Primary
25MB08021500
NJ
2085R0202X
Diagnostic Radiology Physician
OS10292
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126125400
FL
Enumeration date
08/15/2006
Last updated
04/16/2025
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