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1245398197
JACK DE SANTIS
COMMACK, NY
NPI
1245398197
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY PR0047581)
Enumeration Date
2006-12-04
Last Update Date
2007-07-08
Business Address
Mr. JACK DE SANTIS LCSW
368 VETERANS MEMORIAL HIGHWAY SUITE #1
COMMACK, NY 11725-4315
Phone number: 631-543-8779
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Mailing Address
Mr. JACK DE SANTIS LCSW
414 RIDGEFIELD ROAD
HAUPPAUGE, NY 11788-2312
Phone number: 631-361-8865
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