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Organization

AXIS MEDICAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEEPESH PATEL M.D. (PRESIDENT)
(845) 473-8996
Entity
Organization

Contact information

Practice address
15 FULTON AVE, POUGHKEEPSIE, NY 12603-2315
(845) 473-8996
Mailing address
15 FULTON AVE, POUGHKEEPSIE, NY 12603-2315
(845) 473-8996

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
F340980-1
NY
305S00000X
Point of Service
F340980-1
NY
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
F340980-1
NY

Other

Enumeration date
08/13/2016
Last updated
08/13/2016
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