Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DI021924 | NJ |
NPI | 1063593622 |
---|---|
Provider Name | Darryl Engel |
First Address | Oradell, NJ 07649-1508 |
Second Address | Oradell, NJ 07649-1508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |