Provider Demographics
NPI:1770299232
Name:ECKEL, TODD MATTHEW
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:MATTHEW
Last Name:ECKEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 STILES CT
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2221
Mailing Address - Country:US
Mailing Address - Phone:862-213-1850
Mailing Address - Fax:
Practice Address - Street 1:314 ROUTE 15
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:NJ
Practice Address - Zip Code:07885
Practice Address - Country:US
Practice Address - Phone:973-361-9315
Practice Address - Fax:973-361-0544
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02342600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist