Provider Demographics
NPI:1437145745
Name:SANTIAGO-COLON, NYDIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:E
Last Name:SANTIAGO-COLON
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:CARR. 135, KM. 64.2
Mailing Address - Street 2:BOX 188
Mailing Address - City:CASTANER
Mailing Address - State:PR
Mailing Address - Zip Code:00631-0188
Mailing Address - Country:US
Mailing Address - Phone:787-829-2929
Mailing Address - Fax:787-829-2913
Practice Address - Street 1:CARR. 135, KM. 64.2
Practice Address - Street 2:BOX 1003
Practice Address - City:CASTANER
Practice Address - State:PR
Practice Address - Zip Code:00631-1003
Practice Address - Country:US
Practice Address - Phone:787-829-5010
Practice Address - Fax:787-829-2913
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87952080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE94928Medicare UPIN
PR0010030Medicare ID - Type Unspecified