Individual
ISRAEL DURAN SANTIBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 S MAIN ST STE 201, MIDDLETOWN, CT 06457-3649
(860) 358-6486
Mailing address
90 S MAIN ST STE 201, MIDDLETOWN, CT 06457-3649
(860) 358-6486
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
78697
CT
Other
Enumeration date
03/21/2023
Last updated
06/24/2024
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