Provider Demographics
NPI:1114598372
Name:CANEGA, GERARD SANTOS (RN)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:SANTOS
Last Name:CANEGA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8602 AVENUE N APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5114
Mailing Address - Country:US
Mailing Address - Phone:347-701-4795
Mailing Address - Fax:516-472-6694
Practice Address - Street 1:300 E OVERLOOK
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4730
Practice Address - Country:US
Practice Address - Phone:516-472-6616
Practice Address - Fax:516-472-6694
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY729072163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse