Provider Demographics
NPI:1003644477
Name:SANTORO, ELIZABETH ALWINE (PA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ALWINE
Last Name:SANTORO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:6308 BENSEN AVE
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-1104
Mailing Address - Country:US
Mailing Address - Phone:856-558-1574
Mailing Address - Fax:
Practice Address - Street 1:1450 E CHESTNUT AVE STE 3A
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8475
Practice Address - Country:US
Practice Address - Phone:856-794-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00870000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant