Provider Demographics
NPI:1255637385
Name:SANTO, CYNTHIA JANE (BASIC MASTERS OT;LIC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JANE
Last Name:SANTO
Suffix:
Gender:F
Credentials:BASIC MASTERS OT;LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306
Mailing Address - Country:US
Mailing Address - Phone:518-605-1336
Mailing Address - Fax:
Practice Address - Street 1:468 ROUTE 17A
Practice Address - Street 2:DYNAMIC CENTER INC
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921
Practice Address - Country:US
Practice Address - Phone:845-651-2251
Practice Address - Fax:845-651-2258
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist