Provider Demographics
NPI:1922194927
Name:ECKER, VIVIAN (MD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:ECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SHORNECLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2438
Mailing Address - Country:US
Mailing Address - Phone:617-964-7995
Mailing Address - Fax:617-244-7099
Practice Address - Street 1:18 SHORNECLIFFE RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2438
Practice Address - Country:US
Practice Address - Phone:617-964-7995
Practice Address - Fax:617-244-7099
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA567592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry