Individual
CARLA DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
170 HAZARD AVE, ENFIELD, CT 06082
(860) 763-4001
(860) 749-5592
Mailing address
170 HAZARD AVE, ENFIELD, CT 06082
(860) 763-4001
(860) 749-5592
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036524
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001365247
—
CT
Enumeration date
08/18/2006
Last updated
01/28/2013
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