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General NPI Number Information
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NPI Number | 1881800282
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Entity Type | Organization
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Legal Business Name | PAUL AXELRAD AND JACQUELINE ZUCKERBROD
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/15/2011
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Provider Practice Location Address
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Address Line | 4774 US HIGHWAY 9
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City | HOWELL
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State | NJ
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Zip | 07731-3354
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Country | US
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Telephone | 732-363-6222
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Fax | 732-363-6222
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Provider Business Mailing Address
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Address Line | 4774 US HIGHWAY 9
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City | HOWELL
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State | NJ
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Zip | 07731-3354
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Country | US
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Telephone | 732-363-6222
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Fax | 732-363-6222
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Authorized Official
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Title or Position | PARTNER
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Name | DR. PAUL R AXELRAD
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Credential | MD
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Telephone | 732-363-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA05013600
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License Number State | NJ
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