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NPI Code Detail

MEDICARE: DR. ELLEN DIANE DREXLER M.D.

MEDICARE: DR. ELLEN DIANE DREXLER M.D.
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
12084N0400XNeurology Physician138453NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952301855
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELLEN DIANE DREXLER M.D.
Provider Business Mailing Address
First Line : 883 65TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4737
Country : US
Telephone Number : 718-283-5850
Fax Number : 718-635-6082
Provider Business Practice Location Address
First Line : 883 65TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-4737
Country : US
Telephone Number : 718-283-5850
Fax Number : 718-635-6082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/13/2014

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