Provider Demographics
NPI:1417067612
Name:ERHARD, HEATHER A (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:ERHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:A
Other - Last Name:ERHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2 GREENWICH OFFICE PARK STE 210
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5155
Mailing Address - Country:US
Mailing Address - Phone:203-863-0003
Mailing Address - Fax:212-265-1776
Practice Address - Street 1:2425 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5932
Practice Address - Country:US
Practice Address - Phone:718-405-7500
Practice Address - Fax:718-405-0408
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45658208200000X
NY208849208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI04486Medicare UPIN
NY1545F1Medicare PIN