MEDICARE: MRS. LISA JEAN GECKLER

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	3747A0650X	Attendant Care Provider	1750249744	CT

General Provider Information

NPI Number	:	1750249744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA JEAN GECKLER

Provider Business Mailing Address
First Line	:	522 WOODLAND ST
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-1656
Country	:	US
Telephone Number	:	860-944-4281
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 WOODLAND ST
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-1656
Country	:	US
Telephone Number	:	860-944-4281
Fax Number	:

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

Provider Enumeration Date	:	01/10/2026
Last Update Date	:	01/12/2026

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