Provider Demographics
NPI:1215901251
Name:EHRLICH, MILTON P (PHD)
Entity type:Individual
Prefix:DR
First Name:MILTON
Middle Name:P
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CHRISTIE
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1901
Mailing Address - Country:US
Mailing Address - Phone:201-947-5647
Mailing Address - Fax:
Practice Address - Street 1:199 CHRISTIE ST
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1901
Practice Address - Country:US
Practice Address - Phone:201-947-5647
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0727103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3K0665OtherHEALTH NET
NJ13033700OtherMAGELLAN
NJ226942OtherMHN
NJ226942OtherMHN
NJ626177Medicare ID - Type Unspecified