Provider Demographics
NPI:1164457297
Name:ESPOSITO, RICCARDO J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICCARDO
Middle Name:J
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:462 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4628
Mailing Address - Country:US
Mailing Address - Phone:845-339-2222
Mailing Address - Fax:845-338-5228
Practice Address - Street 1:462 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4628
Practice Address - Country:US
Practice Address - Phone:845-339-2222
Practice Address - Fax:845-338-5228
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080005555OtherRAILROAD MEDICARE
NY93A611Medicare PIN