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NPI Code Detail

MEDICARE: ALYSON FINCKE AXELROD DO

MEDICARE: ALYSON FINCKE AXELROD DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianOS015929PA
2208100000XPhysical Medicine & Rehabilitation Physician25MB09594700NJ

General Provider Information

NPI Number : 1225272735
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSON FINCKE AXELROD DO
Provider Business Mailing Address
First Line : 833 CHESTNUT ST STE 520
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4430
Country : US
Telephone Number : 267-592-6191
Fax Number :
Provider Business Practice Location Address
First Line : 2500 ENGLISH CREEK AVE STE 1300
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-5598
Country : US
Telephone Number : 609-677-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 04/02/2019

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