Individual
SUEHEIDI SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-3413
Mailing address
21 SOUTH RD, FARMINGTON, CT 06032-2482
(608) 679-3413
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
69088
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
07/11/2023
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