Provider Demographics
NPI:1376506105
Name:ECKERT, CHRISTOPHER MICHAEL (MS CCCA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:ECKERT
Suffix:
Gender:M
Credentials:MS CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-2336
Mailing Address - Country:US
Mailing Address - Phone:724-387-3073
Mailing Address - Fax:412-291-3109
Practice Address - Street 1:100 5TH AVE
Practice Address - Street 2:STE: 1208
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1821
Practice Address - Country:US
Practice Address - Phone:412-471-4352
Practice Address - Fax:412-291-3109
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000947L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA293759Medicare UPIN
PA293898QZ2Medicare ID - Type Unspecified