Provider Demographics
NPI:1871001743
Name:ECKRICH, PAUL MICHAEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:ECKRICH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 S COLLEGE AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1302
Mailing Address - Country:US
Mailing Address - Phone:302-831-8893
Mailing Address - Fax:302-831-4468
Practice Address - Street 1:540 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1302
Practice Address - Country:US
Practice Address - Phone:302-831-8893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-13
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist