Provider Demographics
NPI:1235443987
Name:SANTIAGO, REBECCA N (MS OTR)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:N
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 OLD ROUTE 17
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-7013
Mailing Address - Country:US
Mailing Address - Phone:914-799-2073
Mailing Address - Fax:
Practice Address - Street 1:35 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771-1805
Practice Address - Country:US
Practice Address - Phone:914-799-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist