Santiago, Cynthia
Santiago, Cynthia is an sole proprietor health care provider with primary practice located at 5 Roosevelt Ave , Port Jefferson Station NY 11776-3336. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Santiago, Cynthia can be contacted via phone (631) 732-6984.Contact Information
Primary practice address
5 Roosevelt Ave
Port Jefferson Station NY 11776-3336
Phone: (631) 732-6984
Fax: (631) 732-7019
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 217808 | New York |
Profile Details
| NPI number | 1003003856 |
|---|---|
| LBN Legal business name | Santiago, Cynthia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2007 |
| Last updated | Dec 19th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003003856 | NPPES |
| New York | MEDICAID | 02162494 |
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