Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 246102 | NY |
N | 207P00000X | Emergency Physician | 25MA08318900 | NJ |
N | 207QA0401X | Family Doctor - Addiction Medicine | 25MA08318900 | NJ |
N | 207RC0200X | Critical Care Medicine | 25MA08318900 | NJ |
N | 2086S0102X | Surgical Critical Care | 246102 | NY |
N | 2086S0102X | Surgical Critical Care | 25MA08318900 | NJ |
NPI | 1497870133 |
---|---|
Provider Name | Dr. Alexander Flaxman |
First Address | Cherry Hill, NJ 08003-4203 |
Second Address | Cherry Hill, NJ 08003-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0157961 | (05) | NJ |
11968642 | CAQH (01) | |
122669 | (02) | NJ |