Provider Demographics
NPI:1912396177
Name:SANTILLO, ASHLEY NICOLE (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:SANTILLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:995 SENATOR KEATING BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2776
Mailing Address - Country:US
Mailing Address - Phone:855-279-3600
Mailing Address - Fax:585-473-9299
Practice Address - Street 1:995 SENATOR KEATING BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2776
Practice Address - Country:US
Practice Address - Phone:855-279-3600
Practice Address - Fax:585-473-9299
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309179363LA2200X
NY664269163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine