Healthcare Provider Details

I. General information

NPI: 1699920504
Provider Name (Legal Business Name): JEANNE FABIAN ENGEL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GEORGE ST 4TH FLR
YORK PA
17403-3676
US

IV. Provider business mailing address

1001 S GEORGE ST 4TH FLR
YORK PA
17403-3676
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-4005
  • Fax: 717-812-2495
Mailing address:
  • Phone: 717-851-4005
  • Fax: 717-812-2495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014-01011
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number250633
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS014893
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number02003849A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: