MEDICARE: DR. RICHARD PEARL ERALI DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	DPM197	TN
2	213ES0103X	Foot & Ankle Surgery Podiatrist	N006001-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912980053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD PEARL ERALI DPM

Provider Business Mailing Address
First Line	:	17 LANSING ST
Second Line	:	AUBURN MEMORIAL MEDICAL SERVICES, PC
City	:	AUBURN
State	:	NY
Zip	:	13021-1983
Country	:	US
Telephone Number	:	315-567-0455
Fax Number	:	315-255-7099

Provider Business Practice Location Address
First Line	:	77 NELSON ST
Second Line	:	SUITE 120
City	:	AUBURN
State	:	NY
Zip	:	13021-1944
Country	:	US
Telephone Number	:	315-252-7559
Fax Number	:	315-253-8104

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	09/22/2014

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