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:
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Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003003856 NPPES
New York MEDICAID 02162494

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