Provider Demographics
NPI:1932461092
Name:ECKHOFF, CAROLYN MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MARIE
Last Name:ECKHOFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 PLANT LN
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6221
Mailing Address - Country:US
Mailing Address - Phone:516-997-3934
Mailing Address - Fax:
Practice Address - Street 1:27 PLANT LN
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6221
Practice Address - Country:US
Practice Address - Phone:516-997-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist