Individual
DR. MICHAEL PHILLIP SANTA MARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1825 MAPLE RD STE 200, WILLIAMSVILLE, NY 14221-2779
(716) 687-8748
(716) 687-8753
Mailing address
1825 MAPLE RD STE 200, BUFFALO, NY 14221-2779
(716) 687-8748
(716) 687-8753
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
014396
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025453102
UNIVERA PROVIDER NUMBER
NY
01
—
000526368004
BLUE CROSS/COMMUNITY BLUE
NY
05
—
02186592
—
NY
01
—
492457
VALUE OPTIONS
NY
01
—
9711291
INDEPENDENT HEALTH
NY
Enumeration date
09/22/2006
Last updated
06/21/2024
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