Provider Demographics
NPI:1770540403
Name:EHRLICH, PAUL M (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MADISON AVE.
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3823
Mailing Address - Country:US
Mailing Address - Phone:646-424-0400
Mailing Address - Fax:646-742-0092
Practice Address - Street 1:161 MADISON AVE.
Practice Address - Street 2:SUITE 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3823
Practice Address - Country:US
Practice Address - Phone:212-685-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108948207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00257745Medicaid
330971Medicare ID - Type Unspecified
B13167Medicare UPIN