Healthcare Provider Details

I. General information

NPI: 1578549838
Provider Name (Legal Business Name): ANELISE ENGEL MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CENTRAL PARK S SUITE 2-D
NEW YORK NY
10019-1628
US

IV. Provider business mailing address

30 CENTRAL PARK S SUITE 2-D
NEW YORK NY
10019-1628
US

V. Phone/Fax

Practice location:
  • Phone: 212-223-0437
  • Fax: 212-319-6179
Mailing address:
  • Phone: 212-223-0437
  • Fax: 212-319-6179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number211830
License Number StateNY

VIII. Authorized Official

Name: ANELISE ENGEL
Title or Position: SOLE PROPRIETER
Credential:
Phone: 212-223-0437