Individual
DANIELLE MARIE DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDN
Contact information
Practice address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 660-2578
Mailing address
456 MIDDLE ST, PORTSMOUTH, NH 03801-5017
(603) 660-2578
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
3658
MA
363A00000X
Physician Assistant
Primary
1440
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3116428
—
NH
Enumeration date
12/10/2015
Last updated
04/04/2022
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