National Provider Identifier Database

MARK DESANTIS, DO – NPI #1053424192
Body Imaging

A Radiology doctor of Osteopathy that specializes in Body Imaging.


Contact Information

MARK DESANTIS, DO
79 MIDDLEVILLE RD
NORTHPORT, NY11768
Phone: 631-261-4400
Fax:
Website:
Specialty Taxonomy Code
* Body Imaging 2085B0100X
Diagnostic Radiology 2085R0202X
Nuclear Medicine 207U00000X

* Indicates primary specialty

NPI Profile & details for MARK DESANTIS

NPI Number 1053424192
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/15/2006
Last updated 04/16/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • FL License #: OS10292
  • NJ License #: 25MB08021500
  • FL Medicaid: 126125400
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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