1104939404 NPI number — DR. SOAMI SANTIAGO DE SNYDER PHD IN AUDIOLOGY

Table of content: DR. SOAMI SANTIAGO DE SNYDER PHD IN AUDIOLOGY (NPI 1104939404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104939404 NPI number — DR. SOAMI SANTIAGO DE SNYDER PHD IN AUDIOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTIAGO DE SNYDER
Provider First Name:
SOAMI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD IN AUDIOLOGY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANTIAGO
Provider Other First Name:
SOAMI
Provider Other Middle Name:
SANTIAGO
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD IN AUDIOLOGY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1104939404
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 370624
Provider Second Line Business Mailing Address:
INSTITUTO DE AUDIOLOGIA AVANZADA
Provider Business Mailing Address City Name:
CAYEY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-738-8850
Provider Business Mailing Address Fax Number:
787-738-8850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE ANTONIO R BARCELO
Provider Second Line Business Practice Location Address:
SUITE 212 SIERRA CAYEY MALL
Provider Business Practice Location Address City Name:
CAYEY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00736-3717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-738-8850
Provider Business Practice Location Address Fax Number:
787-738-8850
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  38129 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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