Provider Demographics
NPI:1295479715
Name:ECKERT, MENNA (CPNP AC-PC)
Entity type:Individual
Prefix:
First Name:MENNA
Middle Name:
Last Name:ECKERT
Suffix:
Gender:F
Credentials:CPNP AC-PC
Other - Prefix:
Other - First Name:MENNA
Other - Middle Name:
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP AC-PC
Mailing Address - Street 1:505 STANDISH PL
Mailing Address - Street 2:
Mailing Address - City:STEWARTSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08886-2523
Mailing Address - Country:US
Mailing Address - Phone:646-525-5755
Mailing Address - Fax:
Practice Address - Street 1:1 ROBERT WOOD JOHNSON PL
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1928
Practice Address - Country:US
Practice Address - Phone:732-258-9448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01272400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics