Individual
AXEL JUERGEN HERRMANNSDOERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 TALLOW WOOD DR, CLIFTON PARK, NY 12065-2807
(518) 373-4444
(518) 373-0663
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
202113
NY
207Q00000X
Family Medicine Physician
202113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01666242
—
NY
Enumeration date
05/02/2006
Last updated
05/27/2021
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