Healthcare Provider Details

I. General information

NPI: 1477996023
Provider Name (Legal Business Name): DELIAMILLE PEREZ-SANTIAGO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

PO BOX 593
GUAYNABO PR
00970-0593
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6440
  • Fax: 570-271-6002
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD467585
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number022788
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: