Provider Demographics
NPI:1245220946
Name:ENGL, LORRAINE (PHD)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:ENGL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 THE MAPLES
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1594
Mailing Address - Country:US
Mailing Address - Phone:716-626-7492
Mailing Address - Fax:716-626-4496
Practice Address - Street 1:37 S CAYUGA RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6705
Practice Address - Country:US
Practice Address - Phone:716-626-7492
Practice Address - Fax:716-626-4496
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012359103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000524408002OtherHEALTH NOW
NY11247BMedicare ID - Type Unspecified