Provider Demographics
NPI:1710202411
Name:EASTMAN, OSHEA BONITA
Entity Type:Individual
Prefix:
First Name:OSHEA
Middle Name:BONITA
Last Name:EASTMAN
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 1:6938 THURSBY AVE
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1138
Mailing Address - Country:US
Mailing Address - Phone:718-634-8187
Mailing Address - Fax:
Practice Address - Street 1:6938 THURSBY AVE
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1138
Practice Address - Country:US
Practice Address - Phone:718-634-8187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY623462-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse