Individual
AMY ECKSTEIN-VANGELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004619
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02347717
—
NY
01
—
P00304555
RR MEDICARE
NY
Enumeration date
11/03/2005
Last updated
11/17/2016
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