Provider Demographics
NPI:1225368467
Name:EHRLICH, ELLIOT (DPT)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7846 TENNYSON CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4142
Mailing Address - Country:US
Mailing Address - Phone:718-866-8082
Mailing Address - Fax:
Practice Address - Street 1:7846 TENNYSON CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4142
Practice Address - Country:US
Practice Address - Phone:718-866-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032291225100000X
FL25458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist