# WANDA SANTOS CIULLA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417460833
- **Gender:** F
- **Credential:** PHYSICIAN ASSISTANT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | 085000243 | NY | — |
| 208D00000X | General Practice Physician | 085000243 | NY | — |
| 363A00000X | Physician Assistant | 085000243 | NY | — |
| 363AM0700X | Medical Physician Assistant | 085000243 | IL | — |
| 363AM0700X | Medical Physician Assistant | 085000243 | NY | Yes |

## Other

- **Enumeration date:** 11/07/2017
- **Last updated:** 11/07/2017