Provider Demographics
NPI:1356380794
Name:ECKSTEIN, KATHRYN A (D C)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:A
Last Name:ECKSTEIN
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 COMMERCE PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2267
Mailing Address - Country:US
Mailing Address - Phone:856-983-5422
Mailing Address - Fax:856-983-6579
Practice Address - Street 1:17000 COMMERCE PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2267
Practice Address - Country:US
Practice Address - Phone:856-983-5422
Practice Address - Fax:856-983-6579
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00575900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor