Provider Demographics
NPI:1386644573
Name:AXELROD, DEBORAH M (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:AXELROD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 34TH ST
Mailing Address - Street 2:3RD FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4750
Mailing Address - Country:US
Mailing Address - Phone:212-731-5365
Mailing Address - Fax:
Practice Address - Street 1:160 E 34TH ST
Practice Address - Street 2:3RD FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4750
Practice Address - Country:US
Practice Address - Phone:212-731-5365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1518592086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB11800Medicare UPIN
NY26E172Medicare ID - Type Unspecified