Provider Demographics
NPI:1821233834
Name:SANTARO, PAULA (RN, LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:SANTARO
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5234 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1338
Mailing Address - Country:US
Mailing Address - Phone:718-779-0933
Mailing Address - Fax:
Practice Address - Street 1:5234 62ND ST
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1338
Practice Address - Country:US
Practice Address - Phone:718-779-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0537481041C0700X
NY343300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse