Provider Demographics
NPI:1598057416
Name:EHRENFELD, JOEL (MD, PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:EHRENFELD
Suffix:
Gender:M
Credentials:MD, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 AVENUE K FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4143
Mailing Address - Country:US
Mailing Address - Phone:718-909-7373
Mailing Address - Fax:
Practice Address - Street 1:1301 AVENUE J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3605
Practice Address - Country:US
Practice Address - Phone:718-909-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032827-1225100000X
NY311541207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine