Provider Demographics
NPI:1598889065
Name:AXEL, ROBERT A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:AXEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BLEECKER ST
Mailing Address - Street 2:SUITE LH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2602
Mailing Address - Country:US
Mailing Address - Phone:212-929-6884
Mailing Address - Fax:212-242-7003
Practice Address - Street 1:350 BLEECKER ST
Practice Address - Street 2:SUITE LH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2602
Practice Address - Country:US
Practice Address - Phone:212-929-6884
Practice Address - Fax:212-242-7003
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6190103TC0700X
NJ2486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical