Provider Demographics
NPI:1902357759
Name:ECKSTEIN, OLIVIA (PA)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ECKSTEIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9016
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:395 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7012
Practice Address - Country:US
Practice Address - Phone:812-932-2387
Practice Address - Fax:812-222-0104
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2021-09-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical