Organization
MARK ERLICH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A ERLICH M.D. (PRESIDENT)
(718) 672-2824
Entity
Organization
Contact information
Practice address
800A 5TH AVE, NEW YORK, NY 10021-7215
(718) 672-2824
(718) 672-4251
Mailing address
800A FIFTH AVENUE, NEW YORK, NY 10021
(718) 672-2824
(718) 672-4251
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
127289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31A18
BLUE CROSS BLUE SHIELD
NY
01
—
3651645
OXFORD
NY
Enumeration date
05/29/2007
Last updated
08/22/2020
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