Healthcare Provider Details

I. General information

NPI: 1023354131
Provider Name (Legal Business Name): WILLIAM ANDREW ERHARDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11985 SOUNDVIEW AVE
SOUTHOLD NY
11971-2748
US

IV. Provider business mailing address

11985 SOUNDVIEW AVE
SOUTHOLD NY
11971-2748
US

V. Phone/Fax

Practice location:
  • Phone: 917-932-4581
  • Fax:
Mailing address:
  • Phone: 917-932-4581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number179528
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number179528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: