Provider Demographics
NPI:1245518166
Name:SANTORO, JOANN (RN)
Entity type:Individual
Prefix:MISS
First Name:JOANN
Middle Name:
Last Name:SANTORO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24810 DEPEW AVE
Mailing Address - Street 2:PH
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1606
Mailing Address - Country:US
Mailing Address - Phone:917-848-5141
Mailing Address - Fax:
Practice Address - Street 1:24810 DEPEW AVE
Practice Address - Street 2:PH
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11363-1606
Practice Address - Country:US
Practice Address - Phone:917-848-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY642269-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse