Provider Demographics
NPI:1356932685
Name:JAMIRA SANTIAGO
Entity type:Organization
Organization Name:JAMIRA SANTIAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:877-438-9335
Mailing Address - Street 1:8645 78TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1045
Mailing Address - Country:US
Mailing Address - Phone:877-438-9335
Mailing Address - Fax:
Practice Address - Street 1:8645 78TH ST
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-1045
Practice Address - Country:US
Practice Address - Phone:877-438-9335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty