MEDICARE: DR. ELAINE R AXELROD PHD

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
1	103TC0700X	Clinical Psychologist	PS004751L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0	OTHER		0

General Provider Information

NPI Number	:	1336618586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE R AXELROD PHD

Provider Business Mailing Address
First Line	:	123 S BROAD ST STE 2048
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19109-1051
Country	:	US
Telephone Number	:	215-732-5187
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 S BROAD ST STE 2048
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19109-1051
Country	:	US
Telephone Number	:	215-732-5187
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	11/16/2018

Similar Medicare Providers

1992224109 — CHARTER HOME HEALTH STAFFING LLC
Practice Location Address:

123 S BROAD ST STE 2048
PHILADELPHIA, PA
19109-1051

Practice Phone: 267-966-7975
Practice Fax:

1649812652 — LAURA VAN SAUN
Practice Location Address:

632 N 2ND ST FRNT 1051
PHILADELPHIA, PA
19123-3046

Practice Phone: 267-225-3283
Practice Fax:

1386249209 — JACARA MCCOY RPH
Practice Location Address:

1051 SOUTH ST
PHILADELPHIA, PA
19147-1910

Practice Phone: 215-829-0670
Practice Fax:

1033714902 — DIANA O AJALA
Practice Location Address:

1051 SOUTH ST
PHILADELPHIA, PA
19147-1910

Practice Phone: 215-829-0670
Practice Fax:

1336744218 — STEPHEN GIARDINO
Practice Location Address:

1051 SOUTH ST
PHILADELPHIA, PA
19147-1910

Practice Phone: 215-829-0670
Practice Fax:

1629669114 — DR. RYAN HUANG PHARMD
Practice Location Address:

1051 SOUTH ST
PHILADELPHIA, PA
19147-1910

Practice Phone: 215-829-0670
Practice Fax:

Directions to “ DR. ELAINE R AXELROD PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.