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NPI Code Detail

MEDICARE: MARIA SANTORO RD

MEDICARE: MARIA SANTORO RD
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
1133V00000XRegistered Dietitian800311NY

General Provider Information

NPI Number : 1649409673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA SANTORO RD
Provider Business Mailing Address
First Line : 5945 161ST ST
Second Line :
City : FLUSHING
State : NY
Zip : 11365-1414
Country : US
Telephone Number : 718-762-3111
Fax Number : 718-353-6315
Provider Business Practice Location Address
First Line : 5945 161ST ST
Second Line :
City : FLUSHING
State : NY
Zip : 11365-1414
Country : US
Telephone Number : 718-762-3111
Fax Number : 718-353-6315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2009
Last Update Date : 07/13/2009

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Directions to “ MARIA SANTORO RD” Practice Location

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