Provider Demographics
NPI:1336253384
Name:ESPOSITO & WRIGHT MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ESPOSITO & WRIGHT MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-295-6815
Mailing Address - Street 1:2960 GRAND CONCOURSE
Mailing Address - Street 2:SUITE L1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1904
Mailing Address - Country:US
Mailing Address - Phone:718-295-6815
Mailing Address - Fax:718-295-6828
Practice Address - Street 1:2960 GRAND CONCOURSE
Practice Address - Street 2:SUITE 1L
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1904
Practice Address - Country:US
Practice Address - Phone:718-295-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I29873Medicare UPIN