Provider Demographics
NPI:1467118976
Name:SANTORO, ANDREA (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SANTORO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 QUARRY LN UNIT 8123
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5033
Mailing Address - Country:US
Mailing Address - Phone:781-526-8303
Mailing Address - Fax:
Practice Address - Street 1:21 QUARRY LN UNIT 8123
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5033
Practice Address - Country:US
Practice Address - Phone:781-526-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered