Provider Demographics
NPI:1720727274
Name:OCEANSIDE AESTHETICS, LLC
Entity Type:Organization
Organization Name:OCEANSIDE AESTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCATEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-413-6375
Mailing Address - Street 1:300 TOLL GATE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4447
Mailing Address - Country:US
Mailing Address - Phone:401-384-7501
Mailing Address - Fax:
Practice Address - Street 1:300 TOLL GATE RD STE 203
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4447
Practice Address - Country:US
Practice Address - Phone:401-384-7501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty