Provider Demographics
NPI:1508873100
Name:ENGELMAN, NEIL (DC)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:ENGELMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MONTOUR BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8581
Mailing Address - Country:US
Mailing Address - Phone:570-784-0960
Mailing Address - Fax:
Practice Address - Street 1:301 MONTOUR BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8581
Practice Address - Country:US
Practice Address - Phone:570-784-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004029-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
EN430236Medicare ID - Type Unspecified
U01378Medicare UPIN