Provider Demographics
NPI:1295253417
Name:ECKHARDT, DARLENE
Entity type:Individual
Prefix:MISS
First Name:DARLENE
Middle Name:
Last Name:ECKHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7886 BLEY RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-9429
Mailing Address - Country:US
Mailing Address - Phone:716-866-2024
Mailing Address - Fax:
Practice Address - Street 1:419 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2106
Practice Address - Country:US
Practice Address - Phone:716-952-4266
Practice Address - Fax:716-363-6958
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer