Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 35120691 | OH |
Y | 208000000X | Pediatrician | 275411 | MA |
NPI | 1699919589 |
---|---|
Provider Name | Stephanie L Santoro |
First Address | Boston, MA 02114-1111 |
Second Address | Boston, MA 02114-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0100688 | (05) | OH |