Provider Demographics
NPI:1114017605
Name:SANTIN, ALESSANDRO (MD)
Entity type:Individual
Prefix:
First Name:ALESSANDRO
Middle Name:
Last Name:SANTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:PO BOX 208063, LSOG 305
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-737-4450
Mailing Address - Fax:203-737-4339
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-737-4450
Practice Address - Fax:203-737-4339
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1766207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143709001Medicaid
AR160052844OtherRAILROAD MEDICARE
5L899Medicare PIN
H42120Medicare UPIN