Provider Demographics
NPI:1154316172
Name:ECKEL, REBECCA R (MD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:R
Last Name:ECKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:132 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-3603
Mailing Address - Country:US
Mailing Address - Phone:518-234-8745
Mailing Address - Fax:518-234-8753
Practice Address - Street 1:132 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-3603
Practice Address - Country:US
Practice Address - Phone:518-234-8745
Practice Address - Fax:518-234-8753
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02550521Medicaid
NY02550521Medicaid
I12846Medicare UPIN