Provider Demographics
NPI:1659636470
Name:ESPINOZA, ALESSANDRA (SI)
Entity Type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:SI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 VAN KLEECK ST APT 2N
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4218
Mailing Address - Country:US
Mailing Address - Phone:646-318-8100
Mailing Address - Fax:
Practice Address - Street 1:51-55 VAN KLEECK STREET APT 2N
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:646-318-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator