Provider Demographics
NPI:1871818393
Name:ALBERT C ESPOSITO
Entity Type:Organization
Organization Name:ALBERT C ESPOSITO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-475-0804
Mailing Address - Street 1:31 OAK ST
Mailing Address - Street 2:STE 8
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2841
Mailing Address - Country:US
Mailing Address - Phone:631-475-0804
Mailing Address - Fax:631-475-0806
Practice Address - Street 1:31 OAK ST
Practice Address - Street 2:STE 8
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2841
Practice Address - Country:US
Practice Address - Phone:631-475-0804
Practice Address - Fax:631-475-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004079-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6354390001Medicare NSC