MEDICARE: MRS. SUZANNE SCHUR EASTWOOD RDN, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	0740000188	VT
2	133V00000X	Registered Dietitian	0655	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0665	OTHER	NH	LICENSED DIETITIAN
2	894114	OTHER	NH	REGISTERED DIETITIAN NUTRITIONIST

General Provider Information

NPI Number	:	1639243421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUZANNE SCHUR EASTWOOD RDN, LD

Provider Business Mailing Address
First Line	:	8 BRICK MILL RD
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-5114
Country	:	US
Telephone Number	:	603-714-3541
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 BRICK MILL RD
Second Line	:
City	:	BEDFORD
State	:	NH
Zip	:	03110-5114
Country	:	US
Telephone Number	:	603-714-3541
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	05/25/2015

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