Healthcare Provider Details

I. General information

NPI: 1023408846
Provider Name (Legal Business Name): GABRIELA SANTAMARIA CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2015
Last Update Date: 02/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

IV. Provider business mailing address

2916 WILLSTON PL APT 301
FALLS CHURCH VA
22044-2851
US

V. Phone/Fax

Practice location:
  • Phone: 202-483-8196
  • Fax:
Mailing address:
  • Phone: 215-962-1794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN1034111
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: