Provider Demographics
NPI:1285278291
Name:ECHO CLINICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:ECHO CLINICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUTCHEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-331-1031
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-0343
Mailing Address - Country:US
Mailing Address - Phone:631-331-1031
Mailing Address - Fax:
Practice Address - Street 1:56 ECHO AVE.
Practice Address - Street 2:STE 1
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2454
Practice Address - Country:US
Practice Address - Phone:631-331-1031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty