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General NPI Number Information
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NPI Number | 1225302003
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Entity Type | Organization
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Legal Business Name | JOSEPH P SANTIAMO MEDICINE P C
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 4268 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6239
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Country | US
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Telephone | 718-967-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 4268 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6239
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Country | US
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Telephone | 718-967-3000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH P SANTIAMO
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Credential | M.D.
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Telephone | 718-967-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 157471
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License Number State | NY
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