Healthcare Provider Details

I. General information

NPI: 1740947621
Provider Name (Legal Business Name): HECTOR DANIEL NIEVES SANTIAGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 5TH STREET HWY STE 100
TEMPLE PA
19560-1739
US

IV. Provider business mailing address

301 S 7TH AVE STE 200
WEST READING PA
19611-1410
US

V. Phone/Fax

Practice location:
  • Phone: 610-208-8800
  • Fax:
Mailing address:
  • Phone: 787-429-1876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT229953
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: