DELORETTA THERESA ECKENRODE (NPI# 1083663058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083663058 |
| Entity Type | Individual |
| Full Name | DELORETTA THERESA ECKENRODE |
| Other Name | DELORETTA THERESA LAWRENCE |
| Credential | NP |
| Practice Address |
67 Sand Pit Rd Ste 308 Danbury CT 06810 |
| Mailing Address |
11350 Mccormick Rd Executive Plaza 1, Suite 501 Hunt Valley MD 21031 |
| Practice Telephone | 2037437264 |
| Practice Fax Number | 2037923920 |
| Mailing Telephone | 4103291071 |
| Mailing Fax Number | 4103291054 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2018-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | F332927 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3709 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008001644 | 05 |
| Street Address |
67 SAND PIT RD STE 308 |
| City | DANBURY |
| State | CT |
| Zip Code | 06810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801877915 | Ross Elliot Dickstein | Anesthesiology | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | 2005-11-07 |
| 1477197671 | Spine Center of Ct, Pllc | Pain Medicine | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | 2019-10-30 |
| 1891262481 | Pain & Spine Specialists of Connecticut, LLC | Non-Pharmacy Dispensing Site | 67 Sand Pit Rd Ste 308, Danbury, CT 06810-4032 | 2018-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235751017 | Jai Karan Singh | Student in an Organized Health Care Education/Training Program | 120 Main Street, Connecticut Institute of Communities, Danbury, CT 06810 | 2020-05-14 |
| 1497377576 | Jahangir Rouzbehani Selakhor | Student in an Organized Health Care Education/Training Program | 24 Hospital Ave. 06810-6099, Danbury, CT 06810 | 2020-05-12 |
| 1255984043 | Michelle Jean Moore | Nurse Practitioner | 95 Locust Avenue 1st Floor Oncology, Stroock Building, Danbury, CT 06810 | 2019-07-20 |
| 1740748755 | Jose Rafael Rivera | Pharmacist | 305 White St, Danbury, CT 06810 | 2019-03-08 |
| 1013406396 | Aswathi Elsa Mathew | Student in an Organized Health Care Education/Training Program | Greater Danbury Community Health Center, 120 Main St, Danbury, CT 06810 | 2018-05-02 |
| 1073001772 | Manish Kumar Gupta | Student in an Organized Health Care Education/Training Program | Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810 | 2018-04-27 |
| 1396232005 | Ayushman Rai Sood | Student in an Organized Health Care Education/Training Program | 24 Hospital Avenue, Danbury Hospital, Danbury, CT 06810 | 2018-04-18 |
| 1366953705 | Connecticut Neurodiagnostics, LLC | Clinic/Center | 83 Wooster Heights Rd., Suite 125, Office 145, Danbury, CT 06810 | 2017-10-12 |
| 1528585569 | Xing Zhu | Dentist | 28 Paulding Ter, Danbury, CT 06810 | 2017-08-29 |
| 1851812606 | Julie Susanne Alferi | Dental Hygienist | 70, Main Street, Danbury, CT 06810 | 2017-07-02 |
| Find all providers in zip 06810 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255984043 | Michelle Jean Moore | Nurse Practitioner | 95 Locust Avenue 1st Floor Oncology, Stroock Building, Danbury, CT 06810 | 2019-07-20 |
| 1578937736 | Roseni D Pease | Nurse Practitioner | 11 Osborne Street, Danbury, CT 06810 | 2015-11-25 |
| 1700128659 | Larissa Camano-selca | Nurse Practitioner | 1202 Eaton Ct, Danbury, CT 06811-4052 | 2013-03-19 |
| 1407197072 | Carolyn Ann Kelly | Nurse Practitioner | 11 Osborne St, Danbury, CT 06810-5918 | 2013-03-07 |
| 1396030383 | Swapna Mathew Varghese | Nurse Practitioner | 13 French St, Danbury, CT 06810-5306 | 2011-06-17 |
| 1750617817 | Amy Smith | Nurse Practitioner | 100 Reserve Rd Ste A4, Danbury, CT 06810-5267 | 2009-10-26 |
| 1831331602 | Tara Marie Ackerly | Nurse Practitioner | 41 Germantown Rd Ste B05, Anticoagulation Center, Danbury, CT 06810-4087 | 2009-03-25 |
| 1558550517 | Marianne Treantafilos | Nurse Practitioner | 30 Milestone Rd., Danbury, CT 06810 | 2007-10-16 |
| 1417175845 | Jennifer S Handau | Nurse Practitioner | 72 Hospital Avenue, Danbury, CT 06810 | 2007-04-23 |
| 1225638950 | Maureen Lore | Nurse Practitioner | 27 Hospital Ave, Danbury, CT 06810-5954 | 2020-10-30 |
| Find all providers in DANBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.