Provider Demographics
NPI:1972550655
Name:EASTMAN, HARRIET C (MD)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:C
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:H
Other - Middle Name:CARROLL
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:287 WESTERN AVE
Mailing Address - Street 2:JOSEPH M SMITH CHC
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-1010
Mailing Address - Country:US
Mailing Address - Phone:617-783-0500
Mailing Address - Fax:
Practice Address - Street 1:287 WESTERN AVE
Practice Address - Street 2:JOSEPH M SMITH CHC
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-1010
Practice Address - Country:US
Practice Address - Phone:617-783-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74888207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine