Provider Demographics
NPI:1891133054
Name:SANTINI, SANDRA MARY
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARY
Last Name:SANTINI
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 1:49 MCMILLAN AVE
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3817
Mailing Address - Country:US
Mailing Address - Phone:914-649-5275
Mailing Address - Fax:
Practice Address - Street 1:49 MCMILLAN AVE
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3817
Practice Address - Country:US
Practice Address - Phone:914-649-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency