Basic Information
Provider Information
NPI: 1730269374
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DESANCHO
FirstName: MARIA TERESA
MiddleName: R.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherLastNameType:  
Mailing Information
Address1: 520 EAST 70TH STREET - STARR 341
Address2:  
City: NEW YORK
State: NY
PostalCode: 10021
CountryCode: US
TelephoneNumber: 2127460373
FaxNumber: 2127467481
Practice Location
Address1: 520 EAST 70TH STREET - STARR 341
Address2:  
City: NEW YORK
State: NY
PostalCode: 10021
CountryCode: US
TelephoneNumber: 2127462844
FaxNumber: 2127463305
Other Information
ProviderEnumerationDate: 10/17/2006
LastUpdateDate: 09/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X203730NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0000X203730NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology
207RX0202X203730NYN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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