Individual
DR. THOMAS MICHAEL ERICHSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1 BUSHWICK RD STE B, LAGRANGE PROFESSIONAL BUILDING, POUGHKEEPSIE, NY 12603-3839
(845) 471-1147
(845) 473-1849
Mailing address
1 BUSHWICK RD STE B, LAGRANGE PROFESSIONAL BUILDING, POUGHKEEPSIE, NY 12603-3839
(845) 471-1147
(845) 473-1849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004036
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10034123 GRP6170
CDPHP PROV #
NY
01
—
141816850
POMCO PROV #
NY
01
—
2218214
AETNA HMO
NY
01
—
2C9390
HEALTHNET PROV #
NY
01
—
597024
MVP PROV. #
NY
01
—
C37061
EMPIRE BC/BS PROV #
NY
01
—
P1954861
OXFORD PROV #
NY
Enumeration date
09/23/2005
Last updated
04/27/2010
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