Provider Demographics
NPI:1407046576
Name:ESPOSITO, ROSE ELEANOR (PH D)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:ELEANOR
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 W 72ND ST
Mailing Address - Street 2:1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2817
Mailing Address - Country:US
Mailing Address - Phone:212-769-0566
Mailing Address - Fax:
Practice Address - Street 1:260 W 72ND ST
Practice Address - Street 2:1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2817
Practice Address - Country:US
Practice Address - Phone:212-769-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006942103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R19980Medicare UPIN
V72961Medicare PIN