Provider Demographics
NPI:1952740011
Name:ESPOSITO, ANNA LYN (RPT)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:LYN
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:ANNALYN
Other - Middle Name:ARANDIA
Other - Last Name:ESPOSITO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPT
Mailing Address - Street 1:16 BLUEBERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4502
Mailing Address - Country:US
Mailing Address - Phone:860-446-8333
Mailing Address - Fax:
Practice Address - Street 1:4 GREENTREE DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4116
Practice Address - Country:US
Practice Address - Phone:860-442-0647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist