Individual
ERNEST M ENZIEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 EMPIRE DR STE 100, RENSSELAER, NY 12144-5730
(518) 475-9518
(518) 286-4859
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
225801
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02337951
—
NY
Enumeration date
10/20/2006
Last updated
01/26/2024
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