Healthcare Provider Details

I. General information

NPI: 1225923618
Provider Name (Legal Business Name): HYACINTH ECCLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 BARTLETT ST
BROOKLYN NY
11206-4463
US

IV. Provider business mailing address

89 BARTLETT ST
BROOKLYN NY
11206-4463
US

V. Phone/Fax

Practice location:
  • Phone: 718-828-2666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number412227
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: