Healthcare Provider Details

I. General information

NPI: 1154796894
Provider Name (Legal Business Name): EASAM IMPROVEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 BROADWAY SUITE 1400
NEW YORK NY
10019-2002
US

IV. Provider business mailing address

1776 BROADWAY SUITE 1400
NEW YORK NY
10019-2002
US

V. Phone/Fax

Practice location:
  • Phone: 646-761-8687
  • Fax: 917-591-2269
Mailing address:
  • Phone: 646-761-8687
  • Fax: 917-591-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLEN BRACKETT
Title or Position: PRESIDENT
Credential:
Phone: 917-836-4460