=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770540403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAUL M EHRLICH M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2006
-----------------------------------------------------
Last Update Date | 05/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 161 MADISON AVE. SUITE 3A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-3823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-685-4225
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 161 MADISON AVE. SUITE 3A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-3823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-424-0400
-----------------------------------------------------
Fax | 646-742-0092
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 108948
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------