Provider Demographics
NPI:1750479481
Name:AHLERT, ERICA GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:GRACE
Last Name:AHLERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 WHITNEY AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2364
Mailing Address - Country:US
Mailing Address - Phone:203-773-1988
Mailing Address - Fax:203-773-1988
Practice Address - Street 1:357 WHITNEY AVE STE 303
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2364
Practice Address - Country:US
Practice Address - Phone:203-773-1988
Practice Address - Fax:203-773-1988
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC287312084P0804X
CT0435802084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry