MEDICARE: ALLAN R SANTIAGO MD

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	207RI0200X	Infectious Disease Physician	250074	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	A400002553	OTHER	NY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	002627671003	OTHER	NY	EMPIRE PLAN
4	100262767101	OTHER	NY	AMERICHOICE
5	250074A22	OTHER		HEALTHFIRST
6	90603000075	OTHER		FIDELIS
7	P4003766	OTHER	NY	OXFORD LIBERTY/FREEDOM PLAN
8	888AA2	OTHER		EMPIRE BLUE CROSS/BLUE SHIELD
9	262573533	OTHER		MAGNACARE
10	9532815	OTHER		CIGNA

General Provider Information

NPI Number	:	1235106527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLAN R SANTIAGO MD

Provider Business Mailing Address
First Line	:	2091 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2549
Country	:	US
Telephone Number	:	718-434-1876
Fax Number	:	347-663-4299

Provider Business Practice Location Address
First Line	:	2091 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2549
Country	:	US
Telephone Number	:	718-434-1876
Fax Number	:	347-663-4299

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

Provider Enumeration Date	:	03/05/2006
Last Update Date	:	10/04/2022

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Directions to “ ALLAN R SANTIAGO MD” Practice Location

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