Provider Demographics
NPI:1073071171
Name:ESPINO, PEDRO J
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:J
Last Name:ESPINO
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 1:255 PARK AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1989
Mailing Address - Country:US
Mailing Address - Phone:508-304-7397
Mailing Address - Fax:508-304-7401
Practice Address - Street 1:255 PARK AVE STE 500
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1989
Practice Address - Country:US
Practice Address - Phone:508-304-7397
Practice Address - Fax:508-304-7401
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program