Provider Demographics
NPI:1891144994
Name:DOS SANTOS, SUSAN (MS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-0966
Mailing Address - Country:US
Mailing Address - Phone:914-376-6869
Mailing Address - Fax:
Practice Address - Street 1:165 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4219
Practice Address - Country:US
Practice Address - Phone:914-376-6869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator