Provider Demographics
NPI:1790527745
Name:ECK, TAYLOR MADISON
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MADISON
Last Name:ECK
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 1:59 WILLET ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5163
Mailing Address - Country:US
Mailing Address - Phone:508-530-1659
Mailing Address - Fax:
Practice Address - Street 1:234 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-9409
Practice Address - Country:US
Practice Address - Phone:908-687-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist