Provider Demographics
NPI:1386699056
Name:SANTANA, ERNESTO J (MD)
Entity type:Individual
Prefix:
First Name:ERNESTO
Middle Name:J
Last Name:SANTANA
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 1:335 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1728
Mailing Address - Country:US
Mailing Address - Phone:585-393-2888
Mailing Address - Fax:585-396-9275
Practice Address - Street 1:335 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1728
Practice Address - Country:US
Practice Address - Phone:585-393-2888
Practice Address - Fax:585-396-9275
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136744207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY136744-0WOtherWORKERS COMP
NY100845BJOtherPREFERRED CARE
NYP010136744OtherBLUE CHOICE
NY00027337901OtherUNIVERA
NY050806000032OtherFIDELIS CARE
NY110247143OtherMEDICARE RAILROAD
NY7599OtherSIDNEY HILLMAN
B77833Medicare UPIN
NY050806000032OtherFIDELIS CARE