Healthcare Provider Details

I. General information

NPI: 1083399463
Provider Name (Legal Business Name): JULIA SANTOMENNA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3548 ROUTE 9 STE 2
OLD BRIDGE NJ
08857-2963
US

IV. Provider business mailing address

1300 YORK AVE
NEW YORK NY
10065-4805
US

V. Phone/Fax

Practice location:
  • Phone: 732-679-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: