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NPI Code Detail

MEDICARE: ROSALI SANTIAGO RN

MEDICARE: ROSALI SANTIAGO 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 NurseRN2295134MA

General Provider Information

NPI Number : 1912840430
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSALI SANTIAGO RN
Provider Business Mailing Address
First Line : 63 MAIN ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-4042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 63 MAIN ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-4042
Country : US
Telephone Number : 508-559-6699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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Directions to “ ROSALI SANTIAGO RN” Practice Location

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