Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 18178 | NJ |
NPI | 1013184993 |
---|---|
Provider Name | Dr. Brian Ehrlich |
First Address | Tallman, NY 10982-0543 |
Second Address | Englewood Cliffs, NJ 07632-2525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2008 |
Last Update Date | 18/01/2012 |