Provider Demographics
NPI:1831723709
Name:ESPOSTI, NICOLE PATRICIA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:PATRICIA
Last Name:ESPOSTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:STOUT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:5 PLAINSBORO ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1915
Mailing Address - Country:US
Mailing Address - Phone:609-372-3220
Mailing Address - Fax:
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1915
Practice Address - Country:US
Practice Address - Phone:609-372-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00576100363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical