MEDICARE: DR. ROBERT ENGEL D.P.M.

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
1	213E00000X	Podiatrist	003008	NY

General Provider Information

NPI Number	:	1962503003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ENGEL D.P.M.

Provider Business Mailing Address
First Line	:	1398 VICTORY BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-3908
Country	:	US
Telephone Number	:	718-981-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	1398 VICTORY BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-3908
Country	:	US
Telephone Number	:	718-981-4515
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	06/18/2008

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