MEDICARE: LOREN SANTANGELO

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	101YM0800X	Mental Health Counselor	012740	NY

General Provider Information

NPI Number	:	1811617228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREN SANTANGELO

Provider Business Mailing Address
First Line	:	10 MONROE BLVD APT 4A
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4356
Country	:	US
Telephone Number	:	516-672-8789
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 MONROE BLVD APT 4A
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4356
Country	:	US
Telephone Number	:	516-672-8789
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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Directions to “ LOREN SANTANGELO ” Practice Location

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