Individual
DR. NICHOLAS SPARTAN SANTAVICCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-5731
Mailing address
51 TOWER PL, YONKERS, NY 10703-2264
(914) 469-6434
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
288543
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2011
Last updated
07/21/2022
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