MEDICARE: JOAN EASTMOND

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	163W00000X	Registered Nurse	420074	NY

General Provider Information

NPI Number	:	1760218820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN EASTMOND

Provider Business Mailing Address
First Line	:	3 YORK DR
Second Line	:
City	:	WHEATLEY HEIGHTS
State	:	NY
Zip	:	11798-1220
Country	:	US
Telephone Number	:	631-615-0772
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 YORK DR
Second Line	:
City	:	WHEATLEY HEIGHTS
State	:	NY
Zip	:	11798-1220
Country	:	US
Telephone Number	:	631-615-0772
Fax Number	:

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

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	09/13/2024

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Directions to “ JOAN EASTMOND ” Practice Location

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