Individual
MR. GREGORY TODD ECKSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1201 N 1ST ST, BLOOMFIELD, NM 87413-5271
(505) 634-3501
(505) 634-3584
Mailing address
1425 E BLANCO BLVD, BLOOMFIELD, NM 87413-6002
(505) 634-3501
(505) 634-3584
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R48383
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64434826
—
NM
Enumeration date
05/16/2007
Last updated
07/09/2007
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