Eastman, Susan
Eastman, Susan is an individual health care provider with primary practice located at 610 E Diamond Ave , Gaithersburg MD 20877-5321. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Eastman, Susan can be contacted via phone (301) 840-3200.Contact Information
Primary practice address
610 E Diamond Ave
Gaithersburg MD 20877-5321
Phone: (301) 840-3200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LC1928 | Maryland |
Profile Details
| NPI number | 1609097997 |
|---|---|
| LBN Legal business name | Eastman, Susan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2007 |
| Last updated | Jul 30th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609097997 | NPPES |
| Maryland | MEDICAID | 816700100 |
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