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NPI Code Detail

MEDICARE: DR. DIANA SANTIAGO M.D.

MEDICARE: DR. DIANA SANTIAGO M.D.
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
1207L00000XAnesthesiology Physician72896CT
2207L00000XAnesthesiology Physician195278NY

Other Identifiers

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

General Provider Information

NPI Number : 1568469690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANA SANTIAGO M.D.
Provider Business Mailing Address
First Line : 19 BRADHURST AVE STE 3100N
Second Line :
City : HAWTHORNE
State : NY
Zip : 10532-2140
Country : US
Telephone Number : 914-909-9018
Fax Number : 914-909-9028
Provider Business Practice Location Address
First Line : 100 WOODS RD
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1530
Country : US
Telephone Number : 914-493-7000
Fax Number : 914-493-5827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 05/17/2024

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