Provider Demographics
NPI:1588924807
Name:SANTIAGO-GALVIN, NYDIA (RN)
Entity type:Individual
Prefix:
First Name:NYDIA
Middle Name:
Last Name:SANTIAGO-GALVIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NYDIA
Other - Middle Name:
Other - Last Name:SANTIAGO-GALVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:57 PROSPECT PARK SW
Mailing Address - Street 2:APT 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5968
Mailing Address - Country:US
Mailing Address - Phone:917-617-8746
Mailing Address - Fax:
Practice Address - Street 1:110 W 97TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6450
Practice Address - Country:US
Practice Address - Phone:212-316-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY606481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse