Provider Demographics
NPI:1619136967
Name:ECKMAN, MONICA M (PAC)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:M
Last Name:ECKMAN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18W NEW YORK AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-1872
Mailing Address - Country:US
Mailing Address - Phone:609-926-1450
Mailing Address - Fax:609-926-8419
Practice Address - Street 1:18W NEW YORK AVENUE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-1872
Practice Address - Country:US
Practice Address - Phone:609-926-1450
Practice Address - Fax:609-926-8419
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00180700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant