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Contact Information

MARK DESANTIS, DO
79 MIDDLEVILLE RD
NORTHPORT, NY11768
 Phone: 631-261-4400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Body Imaging

2085B0100X
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Nuclear Medicine

207U00000X 36 Physician/Nuclear Medicine
Indicates primary specialty

NPI Profile & details for MARK DESANTIS · (Male)

NPI Number 1053424192
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/15/2006
Last updated 04/16/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • FL License # OS10292
  • NJ License # 25MB08021500
  • FL Medicaid 126125400
Hospital affiliation(s) Not Available
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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