Provider Demographics
NPI:1861842130
Name:ECKSTEIN, ALEX
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:ECKSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 E ILIFF AVE
Mailing Address - Street 2:UNIT I
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-7009
Mailing Address - Country:US
Mailing Address - Phone:303-752-1234
Mailing Address - Fax:303-751-1675
Practice Address - Street 1:7800 E ILIFF AVE
Practice Address - Street 2:UNIT I
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-7009
Practice Address - Country:US
Practice Address - Phone:303-752-1234
Practice Address - Fax:303-751-1675
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens