Provider Demographics
NPI:1710112289
Name:EAPEN, FIONA (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:FIONA
Middle Name:
Last Name:EAPEN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 MERRICK RD
Mailing Address - Street 2:STE LL2
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2400
Mailing Address - Country:US
Mailing Address - Phone:516-599-4242
Mailing Address - Fax:516-599-4449
Practice Address - Street 1:2592 MERRICK RD UNIT B
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5742
Practice Address - Country:US
Practice Address - Phone:516-826-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
NY010511363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant