| Marissa T Santos, Md Pc | |
|
6911 Roosevelt Ave # B Woodside NY 11377-2933 | |
| (718) 478-5600 | |
| Not Available |
| Full Name | Marissa T Santos, Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6911 Roosevelt Ave # B, Woodside, New York |
| Authorized Official Name and Position | Marissa T Santos (OWNER) |
| Authorized Official Contact | 2122552333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marissa T Santos, Md Pc 6911 Roosevelt Ave # B Woodside NY 11377-2933 Ph: () - | Marissa T Santos, Md Pc 6911 Roosevelt Ave # B Woodside NY 11377-2933 Ph: (718) 478-5600 |
| NPI Number | 1225153356 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 06/30/2008 |
| Medicare PECOS PAC ID | 6002857331 |
|---|---|
| Medicare Enrollment ID | O20050517001041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225153356 | NPI | - | NPPES |
| 07079G | Other | GHI-MEDICARE | |
| 1531786 | Other | NY | UHC |
| 158042 | Other | NY | VYTRA |
| 84798 | Other | NY | GHI HMO |
| P384086 | Other | NY | OXFORD |
| 113380648SA01 | Other | NY | CARE PLUS |
| 198043B27 | Other | NY | HEALTH FIRST |
| 8433171 | Other | NY | CIGNA |
| 040426017706 | Other | NY | FIDELIS |
| 166AF1 | Other | NY | EMPIRE BCBS |
| 172917 | Other | NY | ELDERPLAN |
| 2592255 | Other | NY | GHI |
| 5816203 | Other | NY | AETNA (HMO) |
| 198043 | Other | NY | HIP |
| 1P1113 | Other | NY | HEALTHNET |
| 100153178601 | Other | NY | UHC (HMO) |
| 11P8501 | Other | NY | NY PRESBYTERIAN |
| SM8043 | Other | NY | AFFINITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 198043 (New York) | Primary |
| Provider Name | Marissa T Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659332377 PECOS PAC ID: 3375595028 Enrollment ID: I20050210000816 |
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