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NPI Code Detail

MEDICARE: DR. BERNARD DAVID RAXLEN MD

MEDICARE: DR. BERNARD DAVID RAXLEN 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
1207RI0200XInfectious Disease Physician170256NY

General Provider Information

NPI Number : 1568686897
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERNARD DAVID RAXLEN MD
Provider Business Mailing Address
First Line : 566 7TH AVE
Second Line : SUITE 502
City : NEW YORK
State : NY
Zip : 10018-1802
Country : US
Telephone Number : 212-799-1121
Fax Number : 212-799-2377
Provider Business Practice Location Address
First Line : 566 7TH AVE
Second Line : SUITE 502
City : NEW YORK
State : NY
Zip : 10018-1802
Country : US
Telephone Number : 212-799-1121
Fax Number : 212-799-2377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 08/26/2015

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