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General NPI Number Information
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NPI Number | 1720455413
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Entity Type | Individual
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Provider Name | STEPHANIE EASTMAN M.S., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 300 GARDEN CITY PLZ SUITE 350
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City | GARDEN CITY
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State | NY
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Zip | 11530-3302
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Country | US
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Telephone | 516-747-9030
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Fax | 516-393-9116
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Provider Business Mailing Address
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Address Line | 147 MAIN AVE
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City | MASTIC
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State | NY
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Zip | 11950-3912
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Country | US
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Telephone |
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 019961
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License Number State | NY
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