MEDICARE: ESPEDITO SANTOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi	B03212	NY

General Provider Information

NPI Number	:	1194385526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESPEDITO SANTOS

Provider Business Mailing Address
First Line	:	740 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-3620
Country	:	US
Telephone Number	:	716-863-1868
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-3620
Country	:	US
Telephone Number	:	716-863-1868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2019
Last Update Date	:	06/18/2019

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Directions to “ ESPEDITO SANTOS ” Practice Location

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