Provider Demographics
NPI:1215706403
Name:ECKERT, NICOLE ALEXANDRA (DC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ALEXANDRA
Last Name:ECKERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CLINTON RD
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-2429
Mailing Address - Country:US
Mailing Address - Phone:201-306-3370
Mailing Address - Fax:
Practice Address - Street 1:21 S SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2624
Practice Address - Country:US
Practice Address - Phone:201-548-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00801600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor