Provider Demographics
NPI:1841554573
Name:SANTOS, SENEYDA ESPERANZA (MASTER DEGREE)
Entity type:Individual
Prefix:MRS
First Name:SENEYDA
Middle Name:ESPERANZA
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MASTER DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 SUMMERFIELD ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5725
Mailing Address - Country:US
Mailing Address - Phone:718-456-6546
Mailing Address - Fax:
Practice Address - Street 1:1626 SUMMERFIELD ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5725
Practice Address - Country:US
Practice Address - Phone:718-456-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY812396174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist