Healthcare Provider Details

I. General information

NPI: 1245217017
Provider Name (Legal Business Name): JAMES B EHRLEIN JR. BSPHARM, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 DAFFODIL AVE
FRANKLIN SQUARE NY
11010-3702
US

IV. Provider business mailing address

106 DAFFODIL AVE
FRANKLIN SQUARE NY
11010-3702
US

V. Phone/Fax

Practice location:
  • Phone: 516-538-1207
  • Fax: 516-354-3790
Mailing address:
  • Phone: 516-538-1207
  • Fax: 516-354-3790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042904
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: