Provider Demographics
NPI:1407099641
Name:SANTORO, THERESE (RN)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:SANTORO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 POTOMAC VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2757
Mailing Address - Country:US
Mailing Address - Phone:301-762-0700
Mailing Address - Fax:
Practice Address - Street 1:1235 POTOMAC VALLEY RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2757
Practice Address - Country:US
Practice Address - Phone:301-762-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO48729163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult