Provider Demographics
NPI:1558250316
Name:SANTANA, CHRISTIAN MARCELIS (NP)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MARCELIS
Last Name:SANTANA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CLINTON PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6636
Mailing Address - Country:US
Mailing Address - Phone:229-630-2189
Mailing Address - Fax:
Practice Address - Street 1:55 CLINTON PL PH 10
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6636
Practice Address - Country:US
Practice Address - Phone:229-630-2189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406904363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty