Provider Demographics
NPI:1528302817
Name:SANTAMOOR, GREGORY HUGH (MS, TVI, SAS)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:HUGH
Last Name:SANTAMOOR
Suffix:
Gender:M
Credentials:MS, TVI, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263A 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5415
Mailing Address - Country:US
Mailing Address - Phone:917-541-6126
Mailing Address - Fax:
Practice Address - Street 1:263A 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5415
Practice Address - Country:US
Practice Address - Phone:917-541-6126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist