Healthcare Provider Details

I. General information

NPI: 1376466557
Provider Name (Legal Business Name): CHRISTIANA JEAN SANTUCCI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

37 BARNARD RD
PATTERSON NY
12563-1732
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7000
  • Fax:
Mailing address:
  • Phone: 845-541-6941
  • 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: