Provider Demographics
NPI:1285474429
Name:EATON, JOHN C
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:EATON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 LINDSLEY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1748
Mailing Address - Country:US
Mailing Address - Phone:973-348-9937
Mailing Address - Fax:
Practice Address - Street 1:54 LINDSLEY AVE APT 2
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1748
Practice Address - Country:US
Practice Address - Phone:973-348-9937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility