1316139165 NPI number — STEPHEN P. ESPOSITO, M.D., P.C.

Table of content: (NPI 1316139165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316139165 NPI number — STEPHEN P. ESPOSITO, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN P. ESPOSITO, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316139165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2619 FRANCIS LEWIS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-224-7186
Provider Business Mailing Address Fax Number:
718-224-1680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2619 FRANCIS LEWIS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-224-7186
Provider Business Practice Location Address Fax Number:
718-224-1680
Provider Enumeration Date:
08/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOEY
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL BILLER
Authorized Official Telephone Number:
718-224-7186

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05639 . This is a "GROUP NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com