Provider Demographics
NPI:1851751101
Name:ESPINOSA, JOSE (RD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BROOK AVE APT B3
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5341
Mailing Address - Country:US
Mailing Address - Phone:201-757-7110
Mailing Address - Fax:
Practice Address - Street 1:77 BROOK AVE APT B3
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5341
Practice Address - Country:US
Practice Address - Phone:201-757-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered