Provider Demographics
NPI:1255314175
Name:SANTANGELO, STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:SANTANGELO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 ROUTE 73 N
Mailing Address - Street 2:40 LAKE CENTER DRIVE SUITE 201A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3425
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0346
Practice Address - Street 1:6981 N PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4205
Practice Address - Country:US
Practice Address - Phone:856-663-4949
Practice Address - Fax:856-663-6076
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07508500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00250860OtherRAILROAD MEDICARE
NJ0126446Medicaid
NJI19154Medicare UPIN
NJ084524QJAMedicare PIN