Provider Demographics
NPI:1427388206
Name:MICHAEL P EHRENHAUS, MD, PC
Entity Type:Organization
Organization Name:MICHAEL P EHRENHAUS, MD, PC
Other - Org Name:NEW YORK CORNEA CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRENHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-425-0903
Mailing Address - Street 1:4402 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3041
Mailing Address - Country:US
Mailing Address - Phone:718-425-0903
Mailing Address - Fax:
Practice Address - Street 1:4402 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3041
Practice Address - Country:US
Practice Address - Phone:718-425-0903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219684207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02201150Medicaid
NY02201150Medicaid