Provider Demographics
NPI:1346039682
Name:EKELMANS, ADRIANUS JOHANNES
Entity type:Individual
Prefix:
First Name:ADRIANUS
Middle Name:JOHANNES
Last Name:EKELMANS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROCKLEDGE AVE APT 408
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1226
Mailing Address - Country:US
Mailing Address - Phone:916-606-6215
Mailing Address - Fax:
Practice Address - Street 1:2 ROCKLEDGE AVE APT 408
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1226
Practice Address - Country:US
Practice Address - Phone:916-606-6215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program