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Dr. Martin B Engelhardt III

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NPI Number Detailed Information

Provider Information:

Name: Dr. Martin B Engelhardt III
Gender: M
Provider License Number If Given: 205777

NPI Information:

NPI: 1639178023
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 8/20/2008

Provider Business Mailing Address:

Address: 1333A NORTH AVE PMB 436
New Rochelle, NY 10804
Phone Number: 9142335822
Fax Number:

Provider Business Practice Location Address:

Address: 77 QUAKER RIDGE RD SUITE 200A
New Rochelle, NY 10804
Phone Number: 9142358224
Fax Number: 9142356940

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: NY

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