Provider Demographics
NPI:1962707521
Name:SANTO, AMY JOELLE (RD)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:JOELLE
Last Name:SANTO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 TRAPPING WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2523
Mailing Address - Country:US
Mailing Address - Phone:914-391-6482
Mailing Address - Fax:
Practice Address - Street 1:43 TRAPPING WAY
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2523
Practice Address - Country:US
Practice Address - Phone:914-391-6482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
01026153133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered