Provider Demographics
NPI:1346354933
Name:ESPINOZA, SHIRLEY A (DC)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:A
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3118
Mailing Address - Country:US
Mailing Address - Phone:631-888-2214
Mailing Address - Fax:631-888-2214
Practice Address - Street 1:797 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-3118
Practice Address - Country:US
Practice Address - Phone:631-888-2214
Practice Address - Fax:631-888-2214
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007498-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX03T61OtherEBCBS
NYX03T61OtherEBCBS
NYU52465Medicare UPIN