Provider Demographics
NPI:1730309410
Name:ENGEL, NEIL RICHARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:RICHARD
Last Name:ENGEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE HAWTHORNE ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732
Mailing Address - Country:US
Mailing Address - Phone:516-922-0125
Mailing Address - Fax:516-922-0216
Practice Address - Street 1:ONE HAWTHORNE ROAD
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732
Practice Address - Country:US
Practice Address - Phone:516-922-0125
Practice Address - Fax:516-922-0216
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice