Provider Demographics
NPI:1043580962
Name:SANTOS, ALAIN
Entity type:Individual
Prefix:
First Name:ALAIN
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 90TH ST
Mailing Address - Street 2:APT. 110
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-2356
Mailing Address - Country:US
Mailing Address - Phone:347-421-1752
Mailing Address - Fax:
Practice Address - Street 1:3225 90TH ST
Practice Address - Street 2:APT. 110
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-2356
Practice Address - Country:US
Practice Address - Phone:347-421-1752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01396900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist