Healthcare Provider Details

I. General information

NPI: 1851588529
Provider Name (Legal Business Name): LYNN ECKROTE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 WYOMING AVE
KINGSTON PA
18704-3831
US

IV. Provider business mailing address

675 WYOMING AVE
KINGSTON PA
18704-3831
US

V. Phone/Fax

Practice location:
  • Phone: 570-288-4205
  • Fax: 570-288-4889
Mailing address:
  • Phone: 570-288-4205
  • Fax: 570-288-4889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052429
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: