Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 40QB00340100 | NJ |
NPI | 1023533965 |
---|---|
Provider Name | Amilynn Eastwood |
First Address | Toms River, NJ 08755-4038 |
Second Address | Howell, NJ 07731-3315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2017 |
Last Update Date | 12/08/2017 |