Individual
SANTIAGO MARCELO THIBAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1470 MADISON AVE, NEW YORK, NY 10029-6542
(646) 592-7803
Mailing address
1 GUSTAVE LEVY PLACE, BOX 1079, NEW YORK, NY 10029-0311
(646) 592-7803
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
294926
NY
207RX0202X
Medical Oncology Physician
Primary
294926
NY
Other
Enumeration date
04/15/2015
Last updated
08/24/2022
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