Provider Demographics
NPI:1669619490
Name:ERLICH, SARA
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:ERLICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4142
Mailing Address - Country:US
Mailing Address - Phone:201-836-7069
Mailing Address - Fax:
Practice Address - Street 1:33 HICKS LN
Practice Address - Street 2:APT. E
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-2026
Practice Address - Country:US
Practice Address - Phone:516-508-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007365-1152W00000X
NJ270A00618400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist