Provider Demographics
NPI:1598262123
Name:EASTERLING, FARYN-ASHLEY
Entity Type:Individual
Prefix:
First Name:FARYN-ASHLEY
Middle Name:
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 RIVERSIDE DR APT 10E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-7119
Mailing Address - Country:US
Mailing Address - Phone:401-864-3269
Mailing Address - Fax:
Practice Address - Street 1:635 RIVERSIDE DR
Practice Address - Street 2:10E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031
Practice Address - Country:US
Practice Address - Phone:401-864-3269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY746363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse