Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 91459 | NY |
NPI | 1003083775 |
---|---|
Provider Name | Dr. Peter Nicholas De Sanctis |
First Address | Shelter Island, NY 11964-1957 |
Second Address | Shelter Island, NY 11964-1957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 13/05/2008 |