1215934724 NPI number — CAROL RINKO SANTORO MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215934724 NPI number — CAROL RINKO SANTORO MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SANTORO

Provider First Name:

CAROL

Provider Middle Name:

RINKO

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

RINKO

Provider Other First Name:

CAROL

Provider Other Middle Name:

JEAN

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

MD

Provider Other Last Name Type Code:

1

NPI Number:

1215934724

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/11/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 14890

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ALBANY

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

12212-4890

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

518-525-5634

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

7 SOUTHWOODS BLVD

Provider Second Line Business Practice Location Address:

CAPITAL CARDIOLOGY ASSOCIATES

Provider Business Practice Location Address City Name:

ALBANY

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

12211-2526

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

518-292-6000

Provider Business Practice Location Address Fax Number:

518-292-6050

Provider Enumeration Date:

06/30/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  220295 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RB0002X , with the licence number: 220295 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000499974002 . This is a "BSNENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 4124266 . This is a "MOHAWK VALLEY PHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 02250526 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 199345 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 040924000012 . This is a "FIDELIS CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 2099403 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 7904293 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 7Q2093 . This is a "EBCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0110234410 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 10060793 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 1467471 . This is a "UHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".