Provider Demographics
NPI:1780671644
Name:ECKSTEIN, PAUL ERIC (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ERIC
Last Name:ECKSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 7SW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-564-2331
Mailing Address - Fax:212-564-7081
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 7SW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-564-2331
Practice Address - Fax:212-564-7081
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005165213ES0103X
NJ25MD00233000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP19911Medicare ID - Type Unspecified
NYU58881Medicare UPIN