Individual
MS. JEANNETTE SANTULLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
197 HALF HOLLOW RD, DIX HILLS, NY 11746-5861
(631) 286-6935
Mailing address
56 JACQUELINE WAY, NORTH BABYLON, NY 11703-1206
(631) 683-4199
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
417230 1
NY
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
F401156-1
NY
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
F4011561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02077636
—
NY
Enumeration date
08/05/2007
Last updated
01/13/2009
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