Provider Demographics
NPI:1144346966
Name:ENGEL, ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-2505
Mailing Address - Country:US
Mailing Address - Phone:203-661-2330
Mailing Address - Fax:203-661-8825
Practice Address - Street 1:733 N BEERS ST
Practice Address - Street 2:SUITE U4
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1528
Practice Address - Country:US
Practice Address - Phone:732-739-2757
Practice Address - Fax:732-739-6722
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07270100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
051579Medicare ID - Type Unspecified