Provider Demographics
NPI:1245534445
Name:SANTIAGO, RHOWEN MAE
Entity type:Individual
Prefix:
First Name:RHOWEN MAE
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MAPLE AVE
Mailing Address - Street 2:C11
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3524
Mailing Address - Country:US
Mailing Address - Phone:631-656-6445
Mailing Address - Fax:
Practice Address - Street 1:77 MAPLE AVE
Practice Address - Street 2:C11
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3524
Practice Address - Country:US
Practice Address - Phone:631-656-6445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY590776163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse