Provider Demographics
NPI:1619738911
Name:ECKSTEIN, KRISTIN ALEXIS (LCAT, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ALEXIS
Last Name:ECKSTEIN
Suffix:
Gender:F
Credentials:LCAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 GREENPOINT AVE APT 4R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2389
Mailing Address - Country:US
Mailing Address - Phone:504-812-1015
Mailing Address - Fax:
Practice Address - Street 1:181 GREENPOINT AVE APT 4R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2389
Practice Address - Country:US
Practice Address - Phone:504-812-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002917221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist