Provider Demographics
NPI:1225236847
Name:ENGEL, ELLIOTT DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:DAVID
Last Name:ENGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 NORRISTOWN RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1250
Mailing Address - Country:US
Mailing Address - Phone:215-443-5709
Mailing Address - Fax:215-443-5716
Practice Address - Street 1:406 NORRISTOWN RD
Practice Address - Street 2:SUITE F
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1250
Practice Address - Country:US
Practice Address - Phone:215-443-5709
Practice Address - Fax:215-443-5716
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-002302-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033486Medicaid
PAT30135Medicare UPIN
PA1033486Medicaid