Echo Blue Enterprise LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00164500 Issued in NJ

Legal business name

ECHO BLUE ENTERPRISE LLC

Practice address

550 W Main St
Boonton, NJ 07005-1168

Phone

(973) 570-4271

Fax

(973) 625-7107

NPI assigned

Jul 16, 2017

Last updated

Jul 16, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kathleen L. Kilcoyne, APN

Title

Owner

Phone

(201) 759-5141

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500163200000",
    "number": "1699297168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MUNSONHURST RD",
            "city": "FRANKLIN",
            "state": "NJ",
            "postal_code": "074161812",
            "telephone_number": "201-759-5141",
            "fax_number": "973-625-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W MAIN ST",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051168",
            "telephone_number": "973-570-4271",
            "fax_number": "973-625-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO BLUE ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-16",
        "last_updated": "2017-07-16",
        "status": "A",
        "authorized_official_last_name": "KILCOYNE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-759-5141",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00164500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Calabrese Dodgen, MA
• Joseph Ryan Donofrio
• Scott Charles Doughty, CADC
• Drug Fair Group, Inc. (Drug Fair of Boonton 54)
• Stacy Lynn Dutka
• Kezie Adaku Egbuchulam, RPH
• Christie Encarnacion
• Shelley English
• Irem E Ercan, LCSW
• Erika Pilato Counseling

• Psychiatric/Mental Health Nurse Practitioner in Boonton, NJ
• Providers in Boonton, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.