Doctor Name: | DR. JOHN DAVID ECKELMAN |
NPI Number: | 1174534093 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 3048 |
Business Practice Address: | 62 Derby St Ste 13 Hingham, MA - 02043 |
Business Phone Number: | 7817494600 |
Business Fax Number: | 7817418341 |
Mailing Address: | 15 Cedarcliff Rd, BRAINTREE |
State: | MA |
Postal Code: | 021843613 |
Phone Number: | 7818204600 |
Fax Number: | 7817418341 |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |