Provider Demographics
NPI:1376385666
Name:AXIM MEDICINE PLLC
Entity type:Organization
Organization Name:AXIM MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-285-6904
Mailing Address - Street 1:357 WHITNEY AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2364
Mailing Address - Country:US
Mailing Address - Phone:781-285-6904
Mailing Address - Fax:
Practice Address - Street 1:357 WHITNEY AVE STE 105
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2364
Practice Address - Country:US
Practice Address - Phone:781-285-6904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health