Provider Demographics
NPI:1851440077
Name:ECKER, PATRICIA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:ECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WOODLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443
Mailing Address - Country:US
Mailing Address - Phone:203-245-4242
Mailing Address - Fax:203-245-3164
Practice Address - Street 1:11 WOODLAND ROAD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443
Practice Address - Country:US
Practice Address - Phone:203-245-4242
Practice Address - Fax:203-245-3164
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030026207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001300269Medicaid
CT001300269Medicaid
E81959Medicare UPIN