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Provider Information for 1477856078


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Ms. KIMBERLY ANN SANTORA Ph.D.


Sex: Female

NPI: 1477856078
Last Updated: 2024-09-23
Certification Date: 2024-09-23

Details

NameValue
NPI1477856078
Enumeration Date2010-12-21
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 263 FARMINGTON AVENUE
FARMINGTON, CT 06030-1104
United States

Phone: 860-679-6700 | Fax:860-679-6736
 
Primary Practice Address 10 TALCOTT NOTCH
FARMINGTON, CT 06032
United States

Phone: 860-679-6700 | Fax:860-679-6736
 
Secondary Practice Address(es)

263 FARMINGTON AVENUE
FARMINGTON, CT 06030-1104
United States

Phone: 860-679-6700 | Fax:860-679-6736
 

190 LENOX ST
NORWOOD, MA 02062-3416
United States

Phone: 203-668-9976 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
ksantora74399@direct.med.uchc.edu
10 Talcott Notch
Farmington, CT 06032
United States
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental Health
No 103T00000X - Psychologist MA10029
Yes 103T00000X - Psychologist CT004631