Provider Demographics
NPI:1316643992
Name:SANTAGATA, LAUREN ASHLEY
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:SANTAGATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-2363
Mailing Address - Country:US
Mailing Address - Phone:631-603-6173
Mailing Address - Fax:
Practice Address - Street 1:98 RANDALL RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-2363
Practice Address - Country:US
Practice Address - Phone:631-603-6173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist