National Provider Identifier
Richard Axelsen, PA
Richard Axelsen, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (607) 319-4563.
Profile Overview
- NPI
- 1063227734
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- February 10, 2025
- Last Updated
- February 10, 2025
Practice Location
- 740 S Meadow St
- Ithaca, NY 14850-5377
Phone: (607) 319-4563
Mailing Address
- 9 Seabrook Ln
- Stony Brook, NY 11790-3323
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1063227734
- Entity Type
- Individual
- Last Name
- Axelsen
- First Name
- Richard
- Credential
- PA
- Mailing Street Address
- 9 Seabrook Ln
- Mailing City
- Stony Brook
- Mailing State
- NY
- Mailing ZIP Code
- 11790-3323
- Mailing Country
- US
- Mailing Phone
- (631) 689-1543
- Practice Street Address
- 740 S Meadow St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5377
- Practice Country
- US
- Practice Phone
- (607) 319-4563
- Enumeration Date
- February 10, 2025
- Last Updated
- February 10, 2025
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- February 10, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)