Provider Demographics
NPI:1730349408
Name:SANTORO, LUCIA A (PA C)
Entity type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:A
Last Name:SANTORO
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
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Mailing Address - Street 1:9540 102ND ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1712
Mailing Address - Country:US
Mailing Address - Phone:718-845-6948
Mailing Address - Fax:718-845-0503
Practice Address - Street 1:9540 102ND ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1712
Practice Address - Country:US
Practice Address - Phone:718-845-6948
Practice Address - Fax:718-845-0503
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY002439363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant