Provider Demographics
NPI:1356360663
Name:SANTILLI, ANTHONY M (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:SANTILLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:124 ROSA RD
Mailing Address - Street 2:SUITE 382
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-386-3691
Mailing Address - Fax:518-386-3503
Practice Address - Street 1:124 ROSA ROAD
Practice Address - Street 2:SUITE 382
Practice Address - City:SCHENECTEDY
Practice Address - State:NY
Practice Address - Zip Code:12308
Practice Address - Country:US
Practice Address - Phone:518-386-3691
Practice Address - Fax:518-386-3503
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME108544207RP1001X
NY224761207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH71397Medicare UPIN