Individual
JOHN ECCLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT-B
Contact information
Practice address
15 DUER LN, STATEN ISLAND, NY 10301-3014
(646) 247-1548
Mailing address
15 DUER LN, STATEN ISLAND, NY 10301-3014
(646) 247-1548
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
106939
NY
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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