Alfonse Desanto III, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT006598 Issued in PA

Practice address

2030 Highland Ave
Bethlehem, PA 18020-8963

Phone

(570) 234-7562

NPI assigned

Nov 21, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1689117707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 HIGHLAND AVENUE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18020",
            "telephone_number": "570-234-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 HIGHLAND AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180208963",
            "telephone_number": "570-234-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTO",
        "first_name": "ALFONSE",
        "name_suffix": "III",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT006598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Desai, CRNP
• Ravi V Desai, M.D
• Shivani Kashyap Desai, MD
• Shree Desai, DO
• Spandan Desai, MD
• Mrunalini Deshmukh, M.D.
• Adam Joseph Desousa, P.T.
• Monika Adam Desousa, MPT
• Haley Detweiler
• Aaron Deutsch, DO

• Athletic Trainer in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.