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NPI Code Detail

MEDICARE: JOHN POL ALER SANTUALLA RN

MEDICARE: JOHN POL ALER SANTUALLA RN
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
1163W00000XRegistered Nurse908963NY

General Provider Information

NPI Number : 1326983719
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN POL ALER SANTUALLA RN
Provider Business Mailing Address
First Line : 2811 QUEENS PLZ N
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4172
Country : US
Telephone Number : 718-391-8300
Fax Number :
Provider Business Practice Location Address
First Line : 2811 QUEENS PLZ N
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4172
Country : US
Telephone Number : 718-391-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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