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General NPI Number Information
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NPI Number | 1821404351
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Entity Type | Individual
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Provider Name | JONOR ESPIRITU SANTIAGO
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Gender | Female
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | METRO COMMUNITY HEALTH CENTER 2324 FOREST AVENUE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1506
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Country | US
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Telephone | 718-447-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 52 GRACE DR
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-2546
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401524
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License Number State | NY
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