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General NPI Number Information
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NPI Number | 1013539311
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Entity Type | Organization
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Legal Business Name | MICAH EASTMAN LPN, MICHAEL EASTMAN RN, OSHEA EASTMAN RN, PLLC
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 555 MADISON AVE STE 545
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City | NEW YORK
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State | NY
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Zip | 10022-3301
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Country | US
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Telephone | 718-913-0944
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Fax | 718-228-8596
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Provider Business Mailing Address
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Address Line | 555 MADISON AVE STE 545
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City | NEW YORK
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State | NY
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Zip | 10022-3301
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Country | US
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Telephone | 718-913-0944
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Fax | 718-228-8596
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR/NURSE
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Name | MR. MICAH J EASTMAN
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Credential | LPN
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Telephone | 718-913-0944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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