Provider Demographics
NPI:1891058541
Name:EHRLICH, JOAN (MSED)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BAY 34TH ST
Mailing Address - Street 2:1R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 BAY 34TH ST
Practice Address - Street 2:1R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5254
Practice Address - Country:US
Practice Address - Phone:917-468-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist