MEDICARE: SANTIAGO PACHECO MA

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1225997745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANTIAGO PACHECO MA

Provider Business Mailing Address
First Line	:	61 S UNION ST APT 406
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-1962
Country	:	US
Telephone Number	:	505-792-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 MOUNTAIN RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87104-1359
Country	:	US
Telephone Number	:	505-557-4656
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ SANTIAGO PACHECO MA” Practice Location

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