Healthcare Provider Details

I. General information

NPI: 1447163795
Provider Name (Legal Business Name): JOELLE ECKAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 PORTLAND AVE BLDG 3
ROCHESTER NY
14621-3095
US

IV. Provider business mailing address

7406 TRILLIUM TRL
VICTOR NY
14564-9730
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-5307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number066114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: