Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 271009 | NY |
NPI | 1043585227 |
---|---|
Provider Name | Dr. Jordan Eric Axelrad |
First Address | New York, NY 10016-2708 |
Second Address | New York, NY 10016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 22/02/2021 |