Provider Demographics
NPI:1174684179
Name:SANTIAGO, YVONNE (RN PNP)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RN PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MIDWAY PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-343-0728
Mailing Address - Fax:845-343-2087
Practice Address - Street 1:400 MIDWAY PARK DRIVE
Practice Address - Street 2:ORANGE PEDIATRIC ASSOCIATES PC
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-343-0728
Practice Address - Fax:845-343-2087
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237327163WP0200X
NYF3801311363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics