Provider Demographics
NPI:1669205951
Name:LABOY, AXEL JOEL
Entity type:Individual
Prefix:
First Name:AXEL
Middle Name:JOEL
Last Name:LABOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2712
Mailing Address - Country:US
Mailing Address - Phone:440-452-5352
Mailing Address - Fax:
Practice Address - Street 1:3310 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2732
Practice Address - Country:US
Practice Address - Phone:440-444-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide