Healthcare Provider Details

I. General information

NPI: 1861746562
Provider Name (Legal Business Name): SAMUEL SAUL ENGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E END AVE APT 5J
NEW YORK NY
10075-1106
US

IV. Provider business mailing address

10 E END AVE APT 5J
NEW YORK NY
10075-1106
US

V. Phone/Fax

Practice location:
  • Phone: 212-535-1705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number140324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: