Provider Demographics
NPI:1780794081
Name:ESPOSITO, ALBERT C (DPM)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:C
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:31 OAK ST
Mailing Address - Street 2:SUITE #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:SUITE #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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY4079-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470566Medicaid
NYT51469Medicare UPIN
NY01470566Medicaid