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Contact Information

KIM AXELRAD, NPP
3600 ROUTE 112
CORAM, NY11727-4116
 Phone: 631-920-8500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KIM AXELRAD · (Female)

NPI # 1942646104
Status Active
Credentials NPP
Entity Individual
Enumeration date 05/15/2013
Last updated 05/15/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • NY License # F4015421
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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