Provider Demographics
NPI:1942860465
Name:SANTI, HAZEL MARIA (CASAC)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:MARIA
Last Name:SANTI
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E 105TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4917
Mailing Address - Country:US
Mailing Address - Phone:212-289-1004
Mailing Address - Fax:
Practice Address - Street 1:127 E 105TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4917
Practice Address - Country:US
Practice Address - Phone:212-289-1004
Practice Address - Fax:212-876-7230
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34861101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)