Provider Demographics
NPI:1548328024
Name:SANTAPAU, GLADYS (LCSW)
Entity type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:
Last Name:SANTAPAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 PAULDING AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462
Mailing Address - Country:US
Mailing Address - Phone:718-931-2593
Mailing Address - Fax:212-757-3555
Practice Address - Street 1:119 WEST 57TH STREET
Practice Address - Street 2:SUITE 1100
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:718-931-2593
Practice Address - Fax:212-757-3555
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055417104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02137268Medicaid
NYNP2Y21Medicare ID - Type Unspecified