Provider Demographics
NPI:1104189992
Name:SAINTILUS, MOLAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLAIN
Middle Name:
Last Name:SAINTILUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RICHLEE CT
Mailing Address - Street 2:APARTMENT 2S
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3619
Mailing Address - Country:US
Mailing Address - Phone:347-255-6026
Mailing Address - Fax:
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4848
Practice Address - Country:US
Practice Address - Phone:203-374-6162
Practice Address - Fax:203-374-1549
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054098207R00000X
NY719291062390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program