Provider Demographics
NPI:1326047424
Name:SANTANIELLO, ROBINA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBINA
Middle Name:RENEE
Last Name:SANTANIELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 DETWILER DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1111
Mailing Address - Country:US
Mailing Address - Phone:717-968-5431
Mailing Address - Fax:
Practice Address - Street 1:1415 DETWILER DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1111
Practice Address - Country:US
Practice Address - Phone:717-968-5431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-045414-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE72665Medicare UPIN