Provider Demographics
NPI:1811211303
Name:ECKHOFF, CAITLIN ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:ECKHOFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ELIZABETH
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:168 DENSLOW RD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3188
Mailing Address - Country:US
Mailing Address - Phone:413-526-9969
Mailing Address - Fax:413-526-9960
Practice Address - Street 1:70 POST OFFICE PARK
Practice Address - Street 2:SUITE 7007
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1287
Practice Address - Country:US
Practice Address - Phone:413-279-1435
Practice Address - Fax:413-279-1438
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001556001Medicare PIN