Carlisle L. St. Martin, MD, PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

153547 Issued in NY

Legal business name

CARLISLE L. ST. MARTIN, MD, PA

Practice address

11510 Queens Blvd
Forest Hills, NY 11375-7060

Phone

(718) 520-0808

Fax

(718) 544-0972

NPI assigned

Mar 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carlisle L. St. Martin, MD

Title

Owner / President

Phone

(718) 520-0808

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1790957835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757060",
            "telephone_number": "718-520-0808",
            "fax_number": "718-544-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757060",
            "telephone_number": "718-520-0808",
            "fax_number": "718-544-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLISLE L. ST. MARTIN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "ST. MARTIN",
        "authorized_official_first_name": "CARLISLE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "718-520-0808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "153547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.