Provider Demographics
NPI:1396052478
Name:SANTOS, RICHARD ARANZASO (OTA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ARANZASO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SNYDER CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1713
Mailing Address - Country:US
Mailing Address - Phone:856-330-4328
Mailing Address - Fax:
Practice Address - Street 1:15 SNYDER CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1713
Practice Address - Country:US
Practice Address - Phone:856-330-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006301224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant