Basic Information
| Provider Information | |||||||||
| NPI: | 1235351248 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAN MARTIN | ||||||||
| FirstName: | RAIMUNDO ANDRES | ||||||||
| MiddleName: | CARDEMIL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 SHERMAN AVE | ||||||||
| Address2: | SUITE 1B | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100401602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129428500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 262 CENTRAL PARK W | ||||||||
| Address2: | SUITE 1B | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100243512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124965818 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 03/10/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 222463 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.