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Individual

MARIA THERESA SANTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
711 COTTAGE GROVE ROAD, BLOOMFIELD, CT 06002-3060
(860) 242-8756
(860) 242-3052
Mailing address
711 COTTAGE GROVE ROAD, BLOOMFIELD, CT 06002-3060
(860) 242-8756
(860) 242-3052

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
053575
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008057720
CT
01
D400221345
MEDICARE
CT
01
P01712135
RAILROAD MEDICARE
CT
Enumeration date
05/10/2010
Last updated
10/20/2016
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