Provider Demographics
NPI:1215070271
Name:ENGEL, JEFFREY M (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:ENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 E 32ND ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5507
Mailing Address - Country:US
Mailing Address - Phone:212-352-0549
Mailing Address - Fax:646-638-1440
Practice Address - Street 1:38 E 32ND ST
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5507
Practice Address - Country:US
Practice Address - Phone:212-352-0549
Practice Address - Fax:646-638-1440
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY201249207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG59512Medicare UPIN
NY66X381Medicare ID - Type Unspecified