Individual
DR. LARA ANNE DESANTI-SISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
386 MONTAUK HWY, SUITE 5, WAINSCOTT, NY 11975
(631) 537-3765
Mailing address
61 N MAIN ST, EAST HAMPTON, NY 11937-2601
(631) 324-9429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
241095-1
NY
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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