Basic Information
Provider Information
NPI: 1417178104
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ECKERT
FirstName: PATRICK
MiddleName: Q
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HYGEIA DRIVE
Address2: SUITE 2300
City: NEWARK
State: DE
PostalCode: 19713
CountryCode: US
TelephoneNumber: 3027333475
FaxNumber: 3027336082
Practice Location
Address1: 4755 OGLETOWN STANTON ROAD
Address2: CHRISTIANA HOSPITAL, SUITE 2E70
City: NEWARK
State: DE
PostalCode: 19718
CountryCode: US
TelephoneNumber: 3027333475
FaxNumber: 3027336082
Other Information
ProviderEnumerationDate: 05/01/2007
LastUpdateDate: 06/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XC1-0010502DEY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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