Provider Demographics
NPI:1497147771
Name:SAENZ-SANTAMARIA, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SAENZ-SANTAMARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 MAIN ST APT 9L
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1856
Mailing Address - Country:US
Mailing Address - Phone:646-641-5644
Mailing Address - Fax:
Practice Address - Street 1:21426 41ST AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2159
Practice Address - Country:US
Practice Address - Phone:718-631-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator