Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | MA064048 | NJ |
NPI | 1306934690 |
---|---|
Provider Name | Dr. Alexander Axelrad |
First Address | Atlantic City, NJ 08401-6713 |
Second Address | Atlantic City, NJ 08401-6713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 25/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F59105 | (02) |