Provider Demographics
NPI:1427042399
Name:MOLHO, ERIC S (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:S
Last Name:MOLHO
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 1:215 WASHINGTON AVENUE EXT
Mailing Address - Street 2:CENTER OF AMC
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5534
Mailing Address - Country:US
Mailing Address - Phone:518-452-0914
Mailing Address - Fax:518-452-5953
Practice Address - Street 1:215 WASHINGTON AVENUE EXT
Practice Address - Street 2:CENTER OF AMC
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5534
Practice Address - Country:US
Practice Address - Phone:518-452-0914
Practice Address - Fax:518-452-5953
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180686-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01374372Medicaid
NY38963CMedicare ID - Type Unspecified
NYF33708Medicare UPIN