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General NPI Number Information
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NPI Number | 1407880784
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Entity Type | Individual
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Provider Name | MISS ERIC I ENGELMYER
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2200 ROSA RD
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City | SCHENECTADY
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State | NY
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Zip | 12309-3717
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Country | US
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Telephone | 518-374-3341
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Fax | 518-374-2329
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Provider Business Mailing Address
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Address Line | 1354 HAWTHORN RD
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City | NISKAYUNA
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State | NY
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Zip | 12309-2502
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Country | US
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Telephone | 518-372-1847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 202919
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License Number State | NY
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