Provider Demographics
NPI:1225355621
Name:EASTON, SAMUELLE (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:SAMUELLE
Middle Name:
Last Name:EASTON
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 MADISON AVE
Mailing Address - Street 2:NECCAM
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3563
Mailing Address - Country:US
Mailing Address - Phone:203-371-1021
Mailing Address - Fax:203-371-1022
Practice Address - Street 1:4154 MADISON AVE
Practice Address - Street 2:NECCAM
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3563
Practice Address - Country:US
Practice Address - Phone:203-371-1021
Practice Address - Fax:203-371-1022
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000491171100000X
NY004204-1171100000X
CT000422175F00000X
VA0121000599171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist