Provider Demographics
NPI:1811950074
Name:ECKER, ROBERT B (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:ECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:491 GOLD STAR HWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340
Mailing Address - Country:US
Mailing Address - Phone:860-445-8020
Mailing Address - Fax:860-445-1665
Practice Address - Street 1:491 GOLD STAR HWY
Practice Address - Street 2:SUITE 310
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340
Practice Address - Country:US
Practice Address - Phone:860-445-8020
Practice Address - Fax:860-445-1665
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD40790207N00000X
CT52390207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400119673Medicare PIN
I58747Medicare UPIN
NYA400005982Medicare PIN
TN3816606Medicare ID - Type Unspecified