Provider Demographics
NPI:1013189299
Name:SANTIAGO, BRIGIDA DE GUZMAN (RNFA)
Entity Type:Individual
Prefix:
First Name:BRIGIDA
Middle Name:DE GUZMAN
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BURNET ST
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1726
Mailing Address - Country:US
Mailing Address - Phone:732-713-2909
Mailing Address - Fax:
Practice Address - Street 1:58 BURNET ST
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1726
Practice Address - Country:US
Practice Address - Phone:732-713-2909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ96870163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant