Healthcare Provider Details

I. General information

NPI: 1730105891
Provider Name (Legal Business Name): RICHARD JOSEPH EHRLICHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST BRIGHAM AND WOMEN'S HOSPITAL
BOSTON MA
02115
US

IV. Provider business mailing address

332 WASHINGTON ST SUITE 215
WELLESLEY MA
02481-6219
US

V. Phone/Fax

Practice location:
  • Phone: 857-307-0870
  • Fax:
Mailing address:
  • Phone: 781-431-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number54341
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: