Provider Demographics
NPI:1770619470
Name:MICHAEL ESPOSITO, M.D., LLC
Entity type:Organization
Organization Name:MICHAEL ESPOSITO, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PICARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-487-8866
Mailing Address - Street 1:5 SUMMIT AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-8503
Mailing Address - Country:US
Mailing Address - Phone:201-487-8866
Mailing Address - Fax:
Practice Address - Street 1:5 SUMMIT AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-8503
Practice Address - Country:US
Practice Address - Phone:201-487-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06365700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty