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General NPI Number Information
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NPI Number | 1528580149
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Entity Type | Individual
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Provider Name | MELANIE SANTIAGO LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3646 37TH ST FL 2
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-1606
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Country | US
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Telephone | 718-897-7904
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Fax | 718-786-8616
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Provider Business Mailing Address
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Address Line | 54 BOERUM ST APT 4S
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City | BROOKLYN
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State | NY
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Zip | 11206-2428
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Country | US
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Telephone | 347-845-3181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100454
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License Number State | NY
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