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Organization
ECHO BLUE ENTERPRISE LLC
Active
Organization
ECHO BLUE ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN L. KILCOYNE APN (OWNER)
(201) 759-5141
Entity
Organization
Contact information
Practice address
550 W MAIN ST, BOONTON, NJ 07005-1168
(973) 570-4271
(973) 625-7107
Mailing address
123 MUNSONHURST RD, FRANKLIN, NJ 07416-1812
(201) 759-5141
(973) 625-7107
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00164500
NJ
Other
Enumeration date
07/16/2017
Last updated
07/16/2017
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