Individual
JACKIE EHRLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305
(718) 226-9269
Mailing address
25 WARD AVE, STATEN ISLAND, NY 10304-2215
(718) 501-8034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
363LW0102X
Women's Health Nurse Practitioner
421301
NY
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
05/30/2012
Last updated
09/25/2020
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