Individual
JOAN C DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 729-2339
Mailing address
98 CARRUTH RD, TEMPLETON, MA 01468-1312
(978) 632-7383
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
042.0012958
VT
2085R0202X
Diagnostic Radiology Physician
19404
NH
2085R0202X
Diagnostic Radiology Physician
Primary
74797
MA
2085R0202X
Diagnostic Radiology Physician
MD11944
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007058150
MEDICARE PTAN
RI
05
—
2022419
—
MA
05
—
JD51209
—
RI
Enumeration date
01/08/2006
Last updated
03/13/2020
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