Provider Demographics
NPI:1598162463
Name:EASTON, CAROLINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:EASTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LOMB MEMORIAL DRIVE
Mailing Address - Street 2:ROOM 2109
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623
Mailing Address - Country:US
Mailing Address - Phone:585-475-4065
Mailing Address - Fax:
Practice Address - Street 1:1 LOMB MEMORIAL DRIVE
Practice Address - Street 2:ROCHESTER INSTITUTE OF TECHNOLOGY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623
Practice Address - Country:US
Practice Address - Phone:585-475-4065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020890-1103TC0700X
CT002261103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical