MEDICARE: ROSALIA SANTOS LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0878141	NY

General Provider Information

NPI Number	:	1013257336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALIA SANTOS LMSW

Provider Business Mailing Address
First Line	:	1316 E 223RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-5804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 W 236TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1748
Country	:	US
Telephone Number	:	718-701-5833
Fax Number	:	888-635-6499

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	02/22/2013

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Directions to “ ROSALIA SANTOS LMSW” Practice Location

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