Provider Demographics
NPI:1841398781
Name:SANTALIZ, RAMON (RN)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:SANTALIZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 HOE AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3668
Mailing Address - Country:US
Mailing Address - Phone:646-209-0253
Mailing Address - Fax:
Practice Address - Street 1:946 HOE AVE
Practice Address - Street 2:APT 1A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3610
Practice Address - Country:US
Practice Address - Phone:646-209-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584046163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY584046Medicaid