Organization Name: | AXIOM MEDICAL P C |
NPI Number: | 1689013443 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL DUME-CHARLES (OWNER) |
Mailing Address: | 1663 Remsen Ave Brooklyn |
State: | NY US |
Postal Code: | 112365233 |
Phone Number: | 7186761650 |
Fax Number: | 7186761653 |
NPI Enumeration Date: | 06/14/2013 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 220943 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |