Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 179528 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 179528 | NY |
NPI | 1023354131 |
---|---|
Provider Name | Dr. William Andrew Erhardt |
First Address | Southold, NY 11971-2748 |
Second Address | Southold, NY 11971-2748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2012 |
Last Update Date | 17/03/2018 |