Healthcare Provider Details

I. General information

NPI: 1760661409
Provider Name (Legal Business Name): JOSEPH D ECKSTEIN CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14058 SW 120TH CT
MIAMI FL
33186-6063
US

IV. Provider business mailing address

801 OSTRUM ST ENROLLMENT CENTER
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 305-315-6882
  • Fax:
Mailing address:
  • Phone: 484-526-6048
  • Fax: 484-526-6048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009588
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: