Individual
HEIDI MICHELLE SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 POST RD W, WESTPORT, CT 06880-4703
(203) 332-3272
Mailing address
300 POST RD W, WESTPORT, CT 06880-4703
(203) 332-3272
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
4630
CT
363AS0400X
Surgical Physician Assistant
Primary
4630
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4630
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
08/21/2019
Last updated
11/13/2024
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