Provider Demographics
NPI:1932287513
Name:BULLARA-SANTANGELO, ANTOINETTE (CSW)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:BULLARA-SANTANGELO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2066
Mailing Address - Country:US
Mailing Address - Phone:718-494-3535
Mailing Address - Fax:
Practice Address - Street 1:14 MONTEREY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-2066
Practice Address - Country:US
Practice Address - Phone:718-494-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0404471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical