Provider Demographics
NPI:1629006341
Name:ENGEL, VICTORIA ANN (DO)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANN
Last Name:ENGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ONEIL ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3510
Mailing Address - Country:US
Mailing Address - Phone:845-340-9506
Mailing Address - Fax:845-340-9509
Practice Address - Street 1:70 ONEIL ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3510
Practice Address - Country:US
Practice Address - Phone:845-340-9506
Practice Address - Fax:845-340-9509
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216135-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1932304532OtherGROUP NPI
NY02640980Medicaid
NY02137300Medicaid
NY1932304532OtherGROUP NPI
NYH33011Medicare UPIN
NY02640980Medicaid
NY02137300Medicaid