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General NPI Number Information
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NPI Number | 1659922540
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Entity Type | Individual
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Provider Name | RYAN S SANTORO
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Gender | Male
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 156 HARVEY RD
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City | LONDONDERRY
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State | NH
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Zip | 03053-7449
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Country | US
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Telephone | 800-657-6517
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Fax |
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Provider Business Mailing Address
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Address Line | 21 AVONDALE DR
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City | CENTEREACH
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State | NY
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Zip | 11720-2837
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Country | US
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Telephone | 631-721-7579
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 044570
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License Number State | NY
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