Provider Demographics
NPI:1235106527
Name:SANTIAGO, ALLAN R (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:R
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2091 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2549
Mailing Address - Country:US
Mailing Address - Phone:718-434-1876
Mailing Address - Fax:347-663-4299
Practice Address - Street 1:2091 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2549
Practice Address - Country:US
Practice Address - Phone:718-434-1876
Practice Address - Fax:347-663-4299
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-05
Last Update Date:2022-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY250074207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02578081Medicaid
NY002627671003OtherEMPIRE PLAN
NYA400002553OtherMEDICARE
NY100262767101OtherAMERICHOICE
250074A22OtherHEALTHFIRST
90603000075OtherFIDELIS
NYP4003766OtherOXFORD LIBERTY/FREEDOM PLAN
888AA2OtherEMPIRE BLUE CROSS/BLUE SHIELD
262573533OtherMAGNACARE
9532815OtherCIGNA
888AA2OtherEMPIRE BLUE CROSS/BLUE SHIELD