Provider Demographics
NPI:1801812490
Name:FUHRER, ELLIOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:
Last Name:FUHRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2108
Mailing Address - Country:US
Mailing Address - Phone:718-972-9115
Mailing Address - Fax:718-972-4461
Practice Address - Street 1:1332 44TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2108
Practice Address - Country:US
Practice Address - Phone:718-972-9115
Practice Address - Fax:718-972-4461
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160239207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY011769970Medicaid
NYE45048Medicare UPIN
NY011769970Medicaid