Provider Demographics
NPI:1689755688
Name:SANTANA, VIVIAN M (RN)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:M
Last Name:SANTANA
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 1:173 MARCELLA RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3118
Mailing Address - Country:US
Mailing Address - Phone:973-887-4820
Mailing Address - Fax:908-901-6098
Practice Address - Street 1:100 ROUTE 206 NORTH
Practice Address - Street 2:
Practice Address - City:PEAPACK
Practice Address - State:NJ
Practice Address - Zip Code:07977
Practice Address - Country:US
Practice Address - Phone:908-901-8169
Practice Address - Fax:908-901-6098
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10359100146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant