Individual
CHRISTINA M EASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 SHIRLEY LN, MEDFORD, NY 11763-1324
(631) 880-3188
Mailing address
40 SHIRLEY LN, MEDFORD, NY 11763-1324
(631) 880-3188
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10307928
NY
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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