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NPI Code Detail

MEDICARE: MARIANA DE LOS SANTOS LMSW

MEDICARE:   MARIANA  DE LOS 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
1104100000XSocial Worker106537NY

General Provider Information

NPI Number : 1174154116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA DE LOS SANTOS LMSW
Provider Business Mailing Address
First Line : 2015 WATSON AVE
Second Line :
City : BRONX
State : NY
Zip : 10472-5403
Country : US
Telephone Number : 917-554-4984
Fax Number :
Provider Business Practice Location Address
First Line : 2015 WATSON AVE
Second Line :
City : BRONX
State : NY
Zip : 10472-5403
Country : US
Telephone Number : 917-554-4984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2020
Last Update Date : 01/29/2020

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Directions to “ MARIANA DE LOS SANTOS LMSW” Practice Location

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