Provider Demographics
NPI:1013138718
Name:SANTIAGO-ESPANA, ANNETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:SANTIAGO-ESPANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 BROADWAY
Mailing Address - Street 2:MC 2606, ALFRED LERNER HALL, 8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7004
Mailing Address - Country:US
Mailing Address - Phone:212-854-2878
Mailing Address - Fax:212-854-9473
Practice Address - Street 1:2920 BROADWAY
Practice Address - Street 2:MC 2606, ALFRED LERNER HALL, 8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7004
Practice Address - Country:US
Practice Address - Phone:212-854-2878
Practice Address - Fax:212-854-9473
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017147103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist