Provider Demographics
NPI:1962526830
Name:SANTOS, ELAINE (PT)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 S MASON RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6258
Mailing Address - Country:US
Mailing Address - Phone:281-394-4591
Mailing Address - Fax:908-756-2447
Practice Address - Street 1:1921 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6258
Practice Address - Country:US
Practice Address - Phone:281-394-4591
Practice Address - Fax:908-756-2447
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00925400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223440358OtherHEALTHNET
NJ223440385OtherOXFORD
NJ223440348OtherAMERIHEALTH
NJ223440358OtherUNITED HEALTHCARE
NJ223440358OtherAETNA
NJ223440358OtherCIGNA