Provider Demographics
NPI:1932447679
Name:ECKER, TRICIA R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:R
Last Name:ECKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 CRESTVIEW DR
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17058-9753
Mailing Address - Country:US
Mailing Address - Phone:717-994-6992
Mailing Address - Fax:
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY UNIT 212
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4476
Practice Address - Country:US
Practice Address - Phone:302-645-8212
Practice Address - Fax:302-645-2199
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055902363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant