Provider Demographics
NPI:1003433889
Name:ESPOSITO, KYLE PATRICK
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:PATRICK
Last Name:ESPOSITO
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 1:385 BRYANT ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1949
Mailing Address - Country:US
Mailing Address - Phone:607-239-3199
Mailing Address - Fax:
Practice Address - Street 1:2049 GEORGE URBAN BLVD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1823
Practice Address - Country:US
Practice Address - Phone:716-901-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist