Provider Demographics
NPI:1225134273
Name:SANTANELLO, ANDREW PETER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PETER
Last Name:SANTANELLO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SULGRAVE AVE # 313
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3654
Mailing Address - Country:US
Mailing Address - Phone:610-955-3625
Mailing Address - Fax:
Practice Address - Street 1:1501 SULGRAVE AVE # 313
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3654
Practice Address - Country:US
Practice Address - Phone:610-955-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04568103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical