Provider Demographics
NPI:1336732718
Name:AMAYA-SANTANA, ROXANA (APN)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:AMAYA-SANTANA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 PAULISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3607
Mailing Address - Country:US
Mailing Address - Phone:973-773-7713
Mailing Address - Fax:973-773-7723
Practice Address - Street 1:960 PAULISON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3607
Practice Address - Country:US
Practice Address - Phone:973-773-7713
Practice Address - Fax:973-773-7723
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01101200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner