Provider Demographics
NPI:1972789873
Name:EHRLICH, EDWARD (OTR)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:MR
Other - First Name:EDDY
Other - Middle Name:
Other - Last Name:EHRLICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:171 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4426
Mailing Address - Country:US
Mailing Address - Phone:718-398-3133
Mailing Address - Fax:
Practice Address - Street 1:51-55 NORTH ROUTE 9W
Practice Address - Street 2:
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993
Practice Address - Country:US
Practice Address - Phone:845-786-4808
Practice Address - Fax:845-786-4951
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005723-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist