Eckenrode, Deloretta Theresa

Eckenrode, Deloretta Theresa is an individual health care provider with primary practice located at 67 Sand Pit Rd Ste 308 , Danbury CT 06810. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Eckenrode, Deloretta Theresa can be contacted via phone (203) 743-7264.

Contact Information

Primary practice address
67 Sand Pit Rd Ste 308 Danbury CT 06810
Phone: (203) 743-7264
Fax: (203) 792-3920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F332927 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3709 Connecticut

Profile Details

NPI number 1083663058
LBN Legal business name Eckenrode, Deloretta Theresa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jun 26th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083663058 NPPES
Connecticut MEDICAID 008001644

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