Provider Demographics
NPI:1316567712
Name:SANTOS, STEVEN JAMES
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:SANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4806
Mailing Address - Country:US
Mailing Address - Phone:646-382-2345
Mailing Address - Fax:
Practice Address - Street 1:2425 WATERBURY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5510
Practice Address - Country:US
Practice Address - Phone:718-822-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-26
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician