Provider Demographics
NPI:1851426720
Name:DAVID SANTORO, PHD.
Entity Type:Organization
Organization Name:DAVID SANTORO, PHD.
Other - Org Name:PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINCIAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTORO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-821-0279
Mailing Address - Street 1:10298 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-3326
Mailing Address - Country:US
Mailing Address - Phone:440-821-0279
Mailing Address - Fax:
Practice Address - Street 1:10298 ANDOVER DR
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-3326
Practice Address - Country:US
Practice Address - Phone:440-821-0279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1414103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000550826OtherANTHEM
OH294305035007OtherMEDICAL MUTUAL
OH0313557Medicaid
OHSACP09783Medicare PIN