Provider Demographics
NPI:1255333217
Name:ESPINA, ELENITA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENITA
Middle Name:
Last Name:ESPINA
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 1:309 STILLSON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3213
Mailing Address - Country:US
Mailing Address - Phone:203-366-8700
Mailing Address - Fax:203-367-8080
Practice Address - Street 1:309 STILLSON RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3213
Practice Address - Country:US
Practice Address - Phone:203-366-8700
Practice Address - Fax:203-367-8080
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024016207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1600001912Medicare ID - Type UnspecifiedMEDICARE#
CTA62011Medicare UPIN