Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 151859 | NY |
NPI | 1386644573 |
---|---|
Provider Name | Deborah M Axelrod |
First Address | New York, NY 10016-4750 |
Second Address | New York, NY 10016-4750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B11800 | (02) | NY |