Individual
TEODORO SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 PATERSON ST, CLINICAL ACADEMIC BUILDING - SUITE 5200B, NEW BRUNSWICK, NJ 08901-1962
(732) 235-6511
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MA27029
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1786300
—
NJ
Enumeration date
11/15/2006
Last updated
02/04/2008
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