MEDICARE: DINA ROSE SANTORA NP

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	363LG0600X	Gerontology Nurse Practitioner	F340622	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487652723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA ROSE SANTORA NP

Provider Business Mailing Address
First Line	:	2021 WINTON RD S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3957
Country	:	US
Telephone Number	:	585-784-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 WINTON RD S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3957
Country	:	US
Telephone Number	:	585-784-6400
Fax Number	:

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	02/13/2013

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