Provider Demographics
NPI:1760853154
Name:ESPOSITO, MICHAEL (MA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3237 GREENPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2005
Mailing Address - Country:US
Mailing Address - Phone:917-673-9826
Mailing Address - Fax:
Practice Address - Street 1:3237 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2005
Practice Address - Country:US
Practice Address - Phone:917-673-9826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst