Provider Demographics
NPI:1912995341
Name:ECKERT, DAVID P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:ECKERT
Suffix:
Gender:M
Credentials:PSYD
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Other - Credentials:
Mailing Address - Street 1:760 BROADWAY DEPARTMENT OF MANAGED CARE ROOM 2B230
Mailing Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8000
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:2 WILLOW ST
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1204
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:718-630-3122
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY009144103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6135431OtherUBH CLAIMS
NYP3100074OtherOXFORD
NY0084917OtherGHI AND VALUEOPTIONS
NYV53041OtherEMPIRE BCBS
NY000735976001OtherONEHEALTH PLAN
NYV53041OtherEMPIRE BCBS