Healthcare Provider Details

I. General information

NPI: 1720392905
Provider Name (Legal Business Name): DAVID ENGIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 07/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 GENESEE ST
BUFFALO NY
14203-1512
US

IV. Provider business mailing address

222 GENESEE ST
BUFFALO NY
14203-1512
US

V. Phone/Fax

Practice location:
  • Phone: 716-855-2866
  • Fax:
Mailing address:
  • Phone: 716-855-2866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number255425-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number255425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: