Provider Demographics
NPI:1114122033
Name:AXELROD-MALAGOLD, SARA H (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:H
Last Name:AXELROD-MALAGOLD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:H
Other - Last Name:AXELROD MALAGOLD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:557 CRANBURY RD STE 3
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5419
Practice Address - Country:US
Practice Address - Phone:732-613-0600
Practice Address - Fax:732-613-0508
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258665207K00000X
NJ25MA08847700207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology