Healthcare Provider Details

I. General information

NPI: 1164256269
Provider Name (Legal Business Name): RACHEL SANTORO MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E LIBERTY ST STE 330
ANN ARBOR MI
48104-2190
US

IV. Provider business mailing address

120 E LIBERTY ST STE 330
ANN ARBOR MI
48104-2190
US

V. Phone/Fax

Practice location:
  • Phone: 734-215-7931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RACHEL SANTORO
Title or Position: SOLE MEMBER
Credential: MD
Phone: 585-880-0974