Active NPI
Vicki Ehrlich, M.D.
- Internal Medicine Physician
- Wallingford, CT
National Provider Identifier
1639150337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 022824
- Practice address
- Gaylord Farms Rd.
Wallingford, CT 06492 - Phone
- (203) 284-2800
- Fax
- (203) 679-3598
- NPI assigned
- Nov 9, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 022824 | CT | Primary |
Addresses
Primary practice location
Gaylord Farms Rd.
Wallingford, CT 06492
Mailing address
Gaylord Farms Rd.
PO Box 400
Wallingford, CT 06492
Phone (203) 284-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1228246 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022824 | CT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639150337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "GAYLORD FARMS RD.",
"address_2": "PO BOX 400",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-284-2800",
"fax_number": "203-679-3598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GAYLORD FARMS RD.",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-284-2800",
"fax_number": "203-679-3598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRLICH",
"first_name": "VICKI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "022824",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1228246",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.