Provider Demographics
NPI:1568539120
Name:EHRLICH, I. B (OD)
Entity Type:Individual
Prefix:DR
First Name:I.
Middle Name:B
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 US HIGHWAY 202/206
Mailing Address - Street 2:SOMERSET SHOPPING CENTER
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2442
Mailing Address - Country:US
Mailing Address - Phone:908-685-0794
Mailing Address - Fax:908-685-1502
Practice Address - Street 1:329 US HIGHWAY 202/206
Practice Address - Street 2:SOMERSET SHOPPING CENTER
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2442
Practice Address - Country:US
Practice Address - Phone:908-685-0794
Practice Address - Fax:908-685-1502
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00409500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ521691Medicare ID - Type UnspecifiedMEDICARE ID#