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DR. MICHAEL PHILLIP SANTA MARIA PH.D.

Clinical Neuropsychologist

North Tonawanda, New York

Provider NPI: 1356440614

Provider Information:
DR. MICHAEL PHILLIP SANTA MARIA PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
445 TREMONT ST SUITE 323 NORTH TONAWANDA, NY 14120 US
Tel: 716-690-2560  Fax: 716-690-2585

Business Mailing Address:
PO BOX 750  NORTH TONAWANDA, NY 14120 US
Tel: 716-690-2560  Fax: 716-690-2585

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NY014396

Other Provider Identifiers:

IssuerNumberStateType
02186592NY05
UNIVERA PROVIDER NUMBER00025453102NY01
BLUE CROSS/COMMUNITY BLUE000526368004NY01
INDEPENDENT HEALTH9711291NY01
VALUE OPTIONS492457NY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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