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NPI Code Detail

MEDICARE: DR. CONNOR ENGEL

MEDICARE:  DR. CONNOR  ENGEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1245172774
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CONNOR ENGEL
Provider Business Mailing Address
First Line : 1136 S DELANO CT W APT 605
Second Line :
City : CHICAGO
State : IL
Zip : 60605-3737
Country : US
Telephone Number : 314-753-8105
Fax Number :
Provider Business Practice Location Address
First Line : 1468 MADISON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10029-6508
Country : US
Telephone Number : 206-790-2318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ DR. CONNOR ENGEL ” Practice Location

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