Provider Demographics
NPI:1730285404
Name:ERLICHMAN, KATHERINE CORMAN (DO)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:CORMAN
Last Name:ERLICHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-7022
Mailing Address - Country:US
Mailing Address - Phone:814-623-1969
Mailing Address - Fax:814-623-5590
Practice Address - Street 1:311 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-7022
Practice Address - Country:US
Practice Address - Phone:814-623-1969
Practice Address - Fax:814-623-5590
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006487L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012470110004Medicaid
PA0991180001Medicare NSC
PA0012470110004Medicaid
PAE84486Medicare UPIN