MEDICARE: KAREN M ECKARDT PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	011555-1	NY
2	2251E1300X	Clinical Electrophysiology Physical Therapist	011555-1	NY

General Provider Information

NPI Number	:	1619914801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN M ECKARDT PT

Provider Business Mailing Address
First Line	:	3385 VETERANS MEMORIAL HWY STE I
Second Line	:
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-7660
Country	:	US
Telephone Number	:	631-665-4560
Fax Number	:	631-665-7213

Provider Business Practice Location Address
First Line	:	131 W MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8315
Country	:	US
Telephone Number	:	631-665-4560
Fax Number	:	631-665-7213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	04/01/2025

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