Healthcare Provider Details

I. General information

NPI: 1962328419
Provider Name (Legal Business Name): DR MICAH ENGEL NURSE PRACTITIONER IN PSYCHIATRY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N 12TH ST STE 706
BROOKLYN NY
11249-1002
US

IV. Provider business mailing address

14131 72ND AVE
FLUSHING NY
11367-2331
US

V. Phone/Fax

Practice location:
  • Phone: 718-673-2002
  • Fax: 855-932-4886
Mailing address:
  • Phone: 718-673-2002
  • Fax: 855-932-4886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MICAH B ENGEL
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 718-673-2002