Provider Demographics
NPI:1033132253
Name:ESPINOZA, JESUS ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:ISABEL
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205
Mailing Address - Country:US
Mailing Address - Phone:718-826-5911
Mailing Address - Fax:718-826-5800
Practice Address - Street 1:1000 CHURCH AVE
Practice Address - Street 2:FLATBUSH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:718-826-4000
Practice Address - Fax:718-826-4075
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1335221208000000X
DC7038INACTIVE208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00271201Medicaid
51K551Medicare ID - Type Unspecified
51K562Medicare ID - Type Unspecified
51K561Medicare ID - Type Unspecified
NY00271201Medicaid