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General NPI Number Information
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NPI Number | 1508891425
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Entity Type | Individual
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Provider Name | THOMAS P. ERHART D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 1500-11 ROUTE 112 SUITES A & B
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-3060
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Country | US
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Telephone | 631-474-4917
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Fax | 631-331-1120
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Provider Business Mailing Address
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Address Line | 1500 ROUTE 112 BLDG 11 SUITE B
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-8054
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Country | US
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Telephone | 631-474-4917
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Fax | 631-331-1048
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 193070
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License Number State | NY
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