MEDICARE: JOEL LAXER MD

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	207R00000X	Internal Medicine Physician	1555561	NY

General Provider Information

NPI Number	:	1447216494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL LAXER MD

Provider Business Mailing Address
First Line	:	70 GLEN COVE RD
Second Line	:	#301
City	:	ROSLYN
State	:	NY
Zip	:	11577-1726
Country	:	US
Telephone Number	:	516-621-1502
Fax Number	:	516-621-1162

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD
Second Line	:
City	:	ROSLYN HGTS
State	:	NY
Zip	:	11577-1726
Country	:	US
Telephone Number	:	516-621-1502
Fax Number	:	516-621-1162

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	12/17/2009

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Directions to “ JOEL LAXER MD” Practice Location

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