Basic Information
| Provider Information | |||||||||
| NPI: | 1457710295 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DAVID ENGELBRECHT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 529 | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON VALLEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105350529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142458400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4487 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104571526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189609000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2016 | ||||||||
| LastUpdateDate: | 02/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | ENGELBRECHT | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9142458400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MEDICAL DOCTOR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.