Healthcare Provider Details

I. General information

NPI: 1972503514
Provider Name (Legal Business Name): ERIC ALAN STECKLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 PICKETT RD UNIT 2314
FAIRFAX VA
22031-8115
US

IV. Provider business mailing address

9000 HAMILTON DR
FAIRFAX VA
22031-3038
US

V. Phone/Fax

Practice location:
  • Phone: 571-266-9876
  • Fax:
Mailing address:
  • Phone: 703-280-2272
  • Fax: 703-280-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101029767
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number114316
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101029767
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: