Provider Demographics
NPI:1952477622
Name:ESPOSITO, MICHAEL JAMES (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:194 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9767
Mailing Address - Country:US
Mailing Address - Phone:518-456-0384
Mailing Address - Fax:518-452-3735
Practice Address - Street 1:614 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3658
Practice Address - Country:US
Practice Address - Phone:518-436-4991
Practice Address - Fax:518-432-6427
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY099629207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00568630Medicaid
NY00568630Medicaid
NYE5312985Medicare PIN