Christopher M Desanto, MD | |
505 Willard Ave, Newington, CT 06111-2650 | |
(860) 666-5601 | |
Not Available |
Full Name | Christopher M Desanto |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 505 Willard Ave, Newington, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679530034 | NPI | - | NPPES |
02379179 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 050285 (Connecticut) | Primary |
Entity Name | Prohealth Physicians Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720194053 PECOS PAC ID: 1355246950 Enrollment ID: O20031205000602 |
Mailing Address | Practice Location Address |
---|---|
Christopher M Desanto, MD 505 Willard Ave, Newington, CT 06111-2650 Ph: (860) 666-5601 | Christopher M Desanto, MD 505 Willard Ave, Newington, CT 06111-2650 Ph: (860) 666-5601 |
Douglas Macgilpin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 505 Willard Avenue, Building 2, Suite C, Newington, CT 06111 Phone: 860-666-5601 Fax: 860-666-2539 | |
Dr. Amy L Baumer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 505 Willard Ave, Building 2, Suite C, Newington, CT 06111 Phone: 860-666-5601 Fax: 860-667-3909 | |
Dr. Jonathan Robert Reidel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 375 Willard Ave, Grove Hill Medical Center, Newington, CT 06111 Phone: 860-666-5167 Fax: 860-665-8168 | |
Laura J Pickett, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 141 Willard Avenue, Newington, CT 06111 Phone: 860-666-5601 | |
Dr. Courtney Lynne Souza, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 375 Willard Ave, Dept Of Pediatrics, Newington, CT 06111 Phone: 860-666-5167 Fax: 860-665-8168 | |
Dr. Richard C Harvey Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 505 Willard Ave, Building 2, Suite C, Newington, CT 06111 Phone: 860-666-5601 Fax: 860-667-3909 | |
Shiji A. Isaac, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 505 Willard Avenue, Building 2, Suite C, Newington, CT 06111 Phone: 860-666-5601 |