Provider Demographics
NPI:1487755864
Name:EASTER, JOYCE ADELE (M D)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ADELE
Last Name:EASTER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 STATE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-1564
Mailing Address - Country:US
Mailing Address - Phone:207-439-4123
Mailing Address - Fax:
Practice Address - Street 1:74 STATE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1564
Practice Address - Country:US
Practice Address - Phone:207-439-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME121712084P0800X
NH73452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C66255Medicare UPIN
MM0758Medicare ID - Type Unspecified