Provider Demographics
NPI:1770263857
Name:SANTAMORENA, ANTHONY JAMES
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JAMES
Last Name:SANTAMORENA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MANNING AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5522
Mailing Address - Country:US
Mailing Address - Phone:914-484-7059
Mailing Address - Fax:
Practice Address - Street 1:31 MANNING AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5522
Practice Address - Country:US
Practice Address - Phone:914-484-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health