Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD031904E | PA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD031904E | PA |
NPI | 1326081241 |
---|---|
Provider Name | Dr. William Santoro |
First Address | Reading, PA 19612-3579 |
Second Address | West Reading, PA 19611-2143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 17/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001164554 | (05) | PA |