Provider Demographics
NPI:1114921582
Name:EHRLICH, HAROLD B (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:B
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1166
Mailing Address - Country:US
Mailing Address - Phone:732-469-3627
Mailing Address - Fax:732-667-3708
Practice Address - Street 1:601 W UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1166
Practice Address - Country:US
Practice Address - Phone:732-469-3627
Practice Address - Fax:732-667-3708
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04637300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53455Medicare UPIN
NJE53455Medicare UPIN