Basic Information
| Provider Information | |||||||||
| NPI: | 1821241381 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTOS | ||||||||
| FirstName: | RAY RYAN | ||||||||
| MiddleName: | CRISOSTOMO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 RXR PLZ FL 13 | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115561301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164530435 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 231 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | HOBOKEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070304738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017541006 | ||||||||
| FaxNumber: | 2017541005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2008 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | NJ84462 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | NJ84462 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 284676 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 25MA08446200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | NJ84462 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.