Healthcare Provider Details

I. General information

NPI: 1518821123
Provider Name (Legal Business Name): EASTON ADVANCED AESTHETICS AND INTEGRATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N WEST ST
EASTON MD
21601-2710
US

IV. Provider business mailing address

120 N WEST ST
EASTON MD
21601-2710
US

V. Phone/Fax

Practice location:
  • Phone: 410-443-0636
  • Fax: 410-690-3056
Mailing address:
  • Phone: 410-443-0636
  • Fax: 410-690-3056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANN CASAMENTO
Title or Position: OWNER / PROVIDER
Credential: FNP-C, APRN
Phone: 301-602-0725