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General NPI Number Information
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NPI Number | 1356413520
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Entity Type | Individual
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Provider Name | LILLIAN ANN EASOM
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 592 ROCKAWAY AVE
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City | BROOKLYN
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State | NY
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Zip | 11212-5539
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Country | US
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Telephone | 718-345-5000
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Fax | 718-346-6747
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Provider Business Mailing Address
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Address Line | 1719 STERLING PL APT 12
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City | BROOKLYN
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State | NY
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Zip | 11233-4566
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Country | US
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Telephone | 917-607-2290
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Fax | 718-346-6747
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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