Individual
JANIS L. ENZENBACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PLLC
Contact information
Practice address
97 CEDAR HILL AVE STE 1B, NYACK, NY 10960-3703
(191) 432-5166
(845) 675-4986
Mailing address
97 CEDAR HILL AVE STE 1B, NYACK, NY 10960-3703
(191) 432-5166
(845) 680-2450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
162853
NY
207VG0400X
Gynecology Physician
Primary
162853-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162853-1
LICENSE
NY
Enumeration date
10/23/2006
Last updated
06/19/2020
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