Healthcare Provider Details

I. General information

NPI: 1982927067
Provider Name (Legal Business Name): ERLICH EYE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 VAN BUREN AVE
TEANECK NJ
07666-4142
US

IV. Provider business mailing address

543 RIVER RD TARGET OPTICAL/ERLICH EYE ASSOCIATES
EDGEWATER NJ
07020-1146
US

V. Phone/Fax

Practice location:
  • Phone: 215-432-5582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00618400
License Number StateNJ

VIII. Authorized Official

Name: DR. SARA ERLICH
Title or Position: OPTOMETRIST/PRESIDENT
Credential: O.D.
Phone: 201-943-1024