Individual
DR. CYNTHIA SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5 ROOSEVELT AVE, PORT JEFFERSON STATION, NY 11776-3336
(631) 732-6984
(631) 732-7019
Mailing address
5 ROOSEVELT AVE, PORT JEFFERSON STATION, NY 11776-2568
(631) 732-6984
(631) 732-7019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217808
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02162494
—
NY
Enumeration date
09/26/2007
Last updated
12/19/2014
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