Individual
DR. THERESA MARIA DISANDRO
Active
Individual
DR. THERESA MARIA DISANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MB08554700
NJ
207RG0100X
Gastroenterology Physician
OT010580
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198561
—
NJ
05
—
102316770
—
PA
Enumeration date
07/03/2008
Last updated
08/14/2026
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