MEDICARE: DR. PERCY A ERACHSHAW DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	2225372	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0101937	OTHER	AMERICHOICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P321036	OTHER	OXFORD

General Provider Information

NPI Number	:	1659362358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PERCY A ERACHSHAW DO

Provider Business Mailing Address
First Line	:	145 SAINT NICHOLAS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-4439
Country	:	US
Telephone Number	:	718-418-5900
Fax Number	:	718-418-4368

Provider Business Practice Location Address
First Line	:	145 SAINT NICHOLAS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-4439
Country	:	US
Telephone Number	:	718-418-5900
Fax Number	:	718-418-4368

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	11/04/2011

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