Iris J Santiago
Individual provider Active NPI Driver · Gardner, MA
NPI 1366969693 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1366969693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- S37399817 (MA)
- Practice address
- 78 Catherine St
Gardner, MA 01440-2017 - Phone
- (978) 758-4994
- Fax
- (978) 669-8003
- NPI assigned
- Aug 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S37399817 | MA | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | S37399817 | MA | Yes |
Addresses
Primary practice location
78 Catherine St
Gardner, MA 01440-2017
Mailing address
78 Catherine St
Gardner, MA 01440-2017
Phone (978) 758-4994
Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.