Basic Information
Provider Information
NPI: 1285763144
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANTIAGO CORNIER
FirstName: ALBERTO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 87
Address2:  
City: MAYAGUEZ
State: PR
PostalCode: 006810087
CountryCode: US
TelephoneNumber: 7877288316
FaxNumber: 7877288316
Practice Location
Address1: 252 SAN JORGE STREET
Address2: SUITE 408
City: SANTURCE
State: PR
PostalCode: 009120000
CountryCode: US
TelephoneNumber: 7877288316
FaxNumber: 7877288316
Other Information
ProviderEnumerationDate: 03/05/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207SG0201X11117PRY Allopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)

No ID Information.


Home