Healthcare Provider Details

I. General information

NPI: 1710351150
Provider Name (Legal Business Name): ELIZABETH U ECKARDT DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 CRYSTAL RUN RD
MIDDLETOWN NY
10941-4028
US

IV. Provider business mailing address

155 CRYSTAL RUN RD
MIDDLETOWN NY
10941-4028
US

V. Phone/Fax

Practice location:
  • Phone: 845-703-6999
  • Fax: 845-703-6297
Mailing address:
  • Phone: 845-703-6999
  • Fax: 845-703-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberF307221
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number113079-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: