Provider Demographics
NPI:1902808017
Name:AXENFIELD, ALLEN (D C)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:AXENFIELD
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 STERLING BLVD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4825
Mailing Address - Country:US
Mailing Address - Phone:917-504-6165
Mailing Address - Fax:
Practice Address - Street 1:1403 STERLING BLVD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4825
Practice Address - Country:US
Practice Address - Phone:917-504-6165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor