Individual
ECKARDT JOHANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.SC.
Contact information
Practice address
4 EXECUTIVE PARK DR, ALBANY, NY 12203-3718
(518) 459-3336
(518) 459-4646
Mailing address
4 EXECUTIVE PARK DR, ALBANY, NY 12203-3718
(518) 459-3336
(518) 459-4646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
175278-1
NY
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
175278-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175278-1
LICENCE
NY
Enumeration date
11/27/2006
Last updated
03/07/2023
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