Provider Demographics
NPI:1649457599
Name:HERBERT I ERSTLING OD
Entity type:Organization
Organization Name:HERBERT I ERSTLING OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:ERSTLING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-965-6875
Mailing Address - Street 1:984 NORTH BROADWAY
Mailing Address - Street 2:L-07
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1319
Mailing Address - Country:US
Mailing Address - Phone:914-965-6875
Mailing Address - Fax:
Practice Address - Street 1:984 NORTH BROADWAY
Practice Address - Street 2:L-07
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1319
Practice Address - Country:US
Practice Address - Phone:914-965-6875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERBERT I ERSTLING OD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001940152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY91186Medicaid
NY91186Medicaid
NY0361310001Medicare NSC