Provider Demographics
NPI:1932593951
Name:SANTOS, CHANTAL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHANTAL
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4222
Mailing Address - Country:US
Mailing Address - Phone:516-216-3176
Mailing Address - Fax:
Practice Address - Street 1:40 GLEN ST STE 1
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2790
Practice Address - Country:US
Practice Address - Phone:516-277-1222
Practice Address - Fax:516-629-6667
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor