Provider Demographics
NPI:1174858930
Name:ERLICH, SHARI (PRESIDENT)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:
Last Name:ERLICH
Suffix:
Gender:F
Credentials:PRESIDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GRAHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4109
Mailing Address - Country:US
Mailing Address - Phone:718-963-1177
Mailing Address - Fax:718-963-3511
Practice Address - Street 1:2 GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4109
Practice Address - Country:US
Practice Address - Phone:718-963-1177
Practice Address - Fax:718-963-3511
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT002946-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist