Provider Demographics
NPI:1043014400
Name:SANTOS, KAYLEY
Entity type:Individual
Prefix:
First Name:KAYLEY
Middle Name:
Last Name:SANTOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CENTER GROVE RD APT J-103
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4450
Mailing Address - Country:US
Mailing Address - Phone:973-234-4721
Mailing Address - Fax:
Practice Address - Street 1:230 POTTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2432
Practice Address - Country:US
Practice Address - Phone:908-894-4931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22227600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse