Provider Demographics
NPI:1194893354
Name:CAASI, SANTIAGO J (MD)
Entity type:Individual
Prefix:DR
First Name:SANTIAGO
Middle Name:J
Last Name:CAASI
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 1:7 STATE ROUTE 27
Mailing Address - Street 2:COLONIAL VILLAGE SUITE 102
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3965
Mailing Address - Country:US
Mailing Address - Phone:732-494-0866
Mailing Address - Fax:732-494-1263
Practice Address - Street 1:7 STATE ROUTE 27
Practice Address - Street 2:COLONIAL VILLAGE SUITE 102
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3965
Practice Address - Country:US
Practice Address - Phone:732-494-0866
Practice Address - Fax:732-494-1263
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA66484208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3K6636OtherHEALTHNET#
NJ60029409OtherHORIZON NJ HEALTH#
NJ7695306Medicaid
NJ2834616000OtherAMERIHEALTH#
NJ8B3461OtherEMPIRE BCBS#
NJ1551250OtherAETNA HMO#
NJ268738OtherAMERIGROUP#
NJ5233619OtherAETNA PPO#
NJ2834616000OtherAMERIHEALTH#
NJ7695306Medicaid